AND-JOS-86

Code
AND-JOS-86
Mercy ID
V-03018-02
Encounter Date
08/18/2009
Last
Andrade
First
Jose
DOB
02/03/1986
County
Fulton
Street
651 North Ave.
City
Atlanta
State
GA
Zip
30354-
Cell
(678) 772-4634
Family Status
Single adult
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Toribio
First
Roasaura
DOB
11/13/1982
Address
N/A
Telephone
(770) 875-0271
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
Alcohol & Drug
YES
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
Lindsey Viridiana Andrade 10/07/2007 Mother GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
J. Manzo
Referred By
linea- Juana