PLA-ANA-79

Code
PLA-ANA-79
Mercy ID
V-03220-01
Encounter Date
12/02/2009
Last
Platero
First
Ana
DOB
04/09/1979
County
Dekalb
Street
2117 Vinagad Walk # 2
City
Atlanta
State
GA
Zip
30316-
Cell
(678) 886-8905
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
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
YES
Consentimiento De Participar
YES

Petitioner

TPO
YES
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
Ashlye Hernandez 04/11/2007 Mother GA/USA
Lesly Hernandez 12/09/2000 Mother GA/USA
Raul Hernandez 05/05/2005 Mother GA/USA

Former Spouse 1 Information

Last
Hernandez
First
Raul
DOB
07/16/1978
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
YES
Intake
G. Landeros
Data Entry
J. Manzo
Referred By
linea-Juana