SAN-HER-69

Code
SAN-HER-69
Mercy ID
V-02910-01
Encounter Date
10/13/2008
Last
Sanchez
First
Hermelinda
DOB
10/28/1969
County
Gwinnett
Street
4155 Satelite Boulevard #414
City
Duluth
State
GA
Zip
30096-
Cell
(404) 645-9562
Family Status
Single parent w/children
COB
Mexico
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
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
Samuel Soriano 04/16/1993 Mother GA/USA
Sandra Soriano 02/26/1996 Mother GA/USA
Sarahi Soriano 02/08/1992 Mother GA/USA
Sebastian Soriano 05/07/2002 Mother GA/USA

Former Spouse 1 Information

Last
Soriano
First
Santana
DOB
07/26/1962
Telephone
N/A
COB
N/A
Home Owner
No
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
linea-Griselda