RME-TNA-71

Code
RME-TNA-71
Mercy ID
V-03309-01
Encounter Date
04/23/2010
Last
Romero
First
Tania
DOB
11/02/1971
County
Gwinnett
Street
6800 Peachtree Ind. Blvd. # 1
City
Doraville
State
GA
Zip
30324-
Home
(407) 844-0631
Family Status
Two parent family w/children
COB
Honduras
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
Padilla
First
Jose
DOB
06/17/1968
Address
N/A
Telephone
N/A
COB
Honduras
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
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
Cristian Padilla 08/16/1995 Parents GA/USA
Driana Padilla 12/31/1991 Parents GA/USA
Driany Padilla 12/31/1991 Parents GA/USA
Saira Padilla 06/22/1990 Adulto/Soltero 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-Juana