VEG-IRM-63

Code
VEG-IRM-63
Mercy ID
V-00123-01
Encounter Date
02/25/2000
Last
Vega
First
Irma
DOB
01/29/1963
County
Dekalb
Street
3490 Chamblee Dunwoody
City
Chamblee
State
GA
Zip
30341-
Home
(770) 986-8841
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Child, not in school

Spouse Information

Last
Cruz
First
Anastacio
DOB
04/15/1971
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
Alcohol & Drug
No
Partner Referred to Tepestri
No
Recidivism/Court
No
New Incident
No
Promesa de Confidencialidad
No
Consentimiento De Participar
No

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

TPO
No
Stay Away Condition
No
Mutual
No
Driver
YES
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Brandan Cruz 01/12/1999 Parents GA/USA
Marlene Cruz 10/10/1991 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
D. Gomez
Referred By