TOR-LET-74

Code
TOR-LET-74
Mercy ID
V-03173-01
Encounter Date
09/24/2009
Last
Torres
First
Leticia
DOB
12/15/1974
County
Barrow
Street
608 Raleigh Ct.
City
Winder
State
GA
Zip
30680-
Cell
(770) 771-1624
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
H.S. equivalency diploma

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
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
Arturo Lopez 01/17/1994 Grandmother Mexico-materna
Mayra Lopez 09/18/2002 Mother GA/USA

Former Spouse 1 Information

Last
Reyes
First
Romeo
DOB
07/19/1970
Telephone
N/A
COB
USA
Home Owner
YES
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-Juana