Code
VAS-URB-69
Mercy ID
V-02226-02
Encounter Date
04/24/2006
Last
Vasquez
First
Urbano
DOB
05/25/1969
County
Dekalb
Street
3421 Cumberland Apt H
City
Chamblee
State
GA
Zip
30341-
Cell
(678) 598-0835
Family Status
Single adult
COB
Guatemala
Gender
Male
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Escalante
First
Elvia
DOB
06/30/1974
Address
N/A
Telephone
N/A
COB
Guatemala
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
YES
Program Completed
No
DFCS Mandated
No
DFACS County
Alcohol & Drug
No
# of DUIs
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
No
Driver License Date
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
Abner Vasquez 02/14/2004 Mother GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
F. Perez
Data Entry
R. Gonzalez
Referred By
Dekalb