REV-LAU-66

Code
REV-LAU-66
Mercy ID
V-02935-01
Encounter Date
11/03/2008
Last
Revillat
First
Laura
DOB
12/01/1966
County
Gwinnett
Street
310 Rebecca St.
City
Lawrenceville
State
GA
Zip
30045-
Home
(678) 242-8519
Cell
(678) 327-6754
Family Status
Two parent family w/children
COB
El Salvador
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
Ramos
First
Juan jose
DOB
05/07/1966
Address
N/A
Telephone
N/A
COB
El Salvador
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
YES
Consentimiento De Participar
YES

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

TPO
No
Stay Away Condition
No
Mutual
No
Driver
YES
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
Genesis Ramos 01/20/1999 Parents GA/USA
Jason Ramos 09/04/1993 Parents GA/USA
Kevin Ramos 08/29/1991 Parents GA/USA
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/TV