YEB-DOR-65

Code
YEB-DOR-65
Mercy ID
V-02925-01
Encounter Date
10/21/2008
Last
Yebra
First
Dora
DOB
07/12/1965
County
Cobb
Street
2106 Dixie Road
City
Gainsville
State
GA
Zip
30504-
Cell
(770) 374-9535
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high 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
Cesar Hernandez 11/03/1987 Mother GA/USA
Felipe Hernandez 06/30/1984 Mother GA/USA
Luis Hernandez 05/13/1989 Mother GA/USA
Margarita Hernandez 07/05/1990 Mother GA/USA

Former Spouse 1 Information

Last
Hernandez
First
Felipe
DOB
03/13/1965
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