ROD-SAN-72

Code
ROD-SAN-72
Mercy ID
V-02741-01
Encounter Date
03/27/2008
Last
Rodriguez
First
Sandra
DOB
02/23/1972
County
Gwinnett
Street
3250 Sweetwater Road
City
Lawrenceville
State
GA
Zip
30044-
Cell
(770) 925-9424
Family Status
Single parent w/children
COB
El Salvador
Gender
Female
Housing
Single Family
Education Level
Grade school

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
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
Adan Rubio 08/23/1993 Mother GA/USA
Karina Arias 09/30/1995 Mother GA/USA
Stephanie Rubio 08/03/1994 Mother GA/USA

Former Spouse 1 Information

Last
Rubio
First
Adan
DOB
05/21/1966
Telephone
N/A
COB
El Salvador
Home Owner
No
NOTES

Media Authoritation

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