COS-JOS-84

Code
COS-JOS-84
Mercy ID
V-02926-01
Encounter Date
10/28/1984
Last
Cosme
First
Josefina
DOB
09/10/1984
County
Dekalb
Street
2561 Mantuket Drive
City
Atlanta
State
GA
Zip
30345-
Home
(404) 321-3552
Cell
(404) 573-1892
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Betancur
First
Martin
DOB
07/29/1970
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
Diana P. Betancur 07/04/2008 Parents GA/USA
Martha Betancur 03/24/2006 Parents GA/USA
NOTES

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
Linea-Juana