BOY-LUV-80

Code
BOY-LUV-80
Mercy ID
V-02369-01
Encounter Date
12/20/2006
Last
Boyzo
First
Luvia
DOB
12/28/1980
County
Clayton
Street
not given
City
Jonesboro
State
GA
Zip
99999-999
Home
(404) 438-4796
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless

Spouse Information

Last
N/A
First
N/A
DOB
N/A
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
Diego Hernandez 11/05/2002 Mother GA/USA
Julietta Hernandez 07/22/2005 Mother GA/USA
Lizette Hernandez 08/25/1999 Mother 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