PET-DIE-65

Code
PET-DIE-65
Mercy ID
V-00182-01
Encounter Date
04/16/2001
Last
Petatan
First
Diega
DOB
11/14/1964
County
Fulton
Street
145 Northwood Dr Apt B-7
City
Atlanta
State
GA
Zip
30342-
Cell
(404) 438-4071
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
N/A
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
YES
Consentimiento De Participar
YES

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
Claudia Herrera 11/11/1991 Parents GA/USA
Emily Herrera 07/23/2002 Mother GA/USA
Victor Herrera Jr. 07/05/1990 Parents GA/USA

Former Spouse 1 Information

Last
Herrera
First
Victor
DOB
11/12/1970
Telephone
(770) 480-5298
COB
N/A
Home Owner
No
NOTES
Direccion de Victor Herrera Papa 5801 King Sport Dr. Apt. 136

Media Authoritation

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