CAL-LAU-72

Code
CAL-LAU-72
Mercy ID
V-02323-01
Encounter Date
08/29/2006
Last
Javier
First
Laura
DOB
09/19/1972
County
Cobb
Street
6109 Black Hawk
City
Mableton
State
GA
Zip
30126-
Cell
(678) 259-9879
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Some College

Spouse Information

Last
Mendoza
First
Armando
DOB
10/22/1966
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
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
YES
Consentimiento De Participar
YES

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

TPO
No
Stay Away Condition
No
Mutual
No
Driver
No
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
Emiliano mendoza 01/24/2004 Parents GA/USA
Karen Mendoza 07/23/2001 Parents GA/USA
Marco Antonio Mendoza 12/28/1989 Parents GA/USA
Octavio Mendoza 09/12/2006 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By