ROD-MAR-55

Code
ROD-MAR-55
Mercy ID
V-02922-01
Encounter Date
10/22/2008
Last
Rodriguez
First
Maria victoria
DOB
09/08/1955
County
Gwinnett
Street
3051 Morris Lake
City
Lawrenceville
State
GA
Zip
30044-
Home
(770) 717-5678
Cell
(770) 361-7937
Family Status
Adult couple-no children
COB
Colombia
Gender
Female
Housing
Single Family
Education Level
College Degree

Spouse Information

Last
Rodriguez
First
Eduardo
DOB
07/11/1959
Address
N/A
Telephone
N/A
COB
Puerto Rico
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
No
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
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
Walk in-OLL