ALM-CLA-69

Code
ALM-CLA-69
Mercy ID
V-02839-01
Encounter Date
07/01/2008
Last
Almazan
First
Claudia
DOB
04/22/1969
County
Dekalb
Street
999 Mexico
City
Mexico
State
MX
Zip
99999-
Home
(442) 218-3292
Cell
(678) 600-3041
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
College Degree

Spouse Information

Last
Alarcon
First
Rafael
DOB
12/27/1968
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
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
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
Maria F. Almazan 09/21/1990 Mother Mexico
Maria Jose Almazan 07/24/1994 Mother Mexico
Valeria Franco 02/10/2002 Mother Mexico

Former Spouse 1 Information

Last
Almazan
First
Fernando
DOB
03/21/1970
Telephone
N/A
COB
N/A
Home Owner
No
NOTES
Estos telefonos son de Mexico y se marca por delante el 011-52-…

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
PADV-Janet