DIA-ARA-75

Code
DIA-ARA-75
Mercy ID
V-02398-01
Encounter Date
01/23/2007
Last
Diaz
First
Araceli
DOB
07/31/1975
County
Hall
Street
5216 Ramble Train Lot 141
City
Buford
State
GA
Zip
30518-
Home
(678) 546-6348
Cell
(678) 255-5101
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Diaz
First
Francisco
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
YES
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
Brian Diaz 12/26/1998 Parents GA/USA
Francisco Javier Diaz 06/12/1997 Parents GA/USA
Karla Lucero Diaz 12/05/2006 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