CAR-AUR-84

Code
CAR-AUR-84
Mercy ID
V-02930-01
Encounter Date
10/29/2008
Last
Carrillo
First
Aurelia
DOB
01/20/1984
County
Fulton
Street
3060 Del Mar lane
City
Atlanta
State
GA
Zip
30311-
Cell
(404) 446-6423
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
01/18/1982
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
YES
Consentimiento De Participar
YES

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
Jhogan Carillo 09/20/2003 Mother GA/USA
Solange Hernandez 08/19/2000 Grandmother Mexico-Materna

Former Spouse 1 Information

Last
Hernandez
First
Manuel
DOB
01/18/1982
Telephone
N/A
COB
Mexico
Home Owner
No
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
Walk in - amiga