RIZ-REY-87

Code
RIZ-REY-87
Mercy ID
V-03321-01
Encounter Date
05/03/2010
Last
Rizo
First
Reyes
DOB
01/06/1987
County
Dekalb
Street
3658 Buford Hwy. Apt. C-26
City
Atlanta
State
GA
Zip
30329-
Cell
(678) 830-3540
Family Status
Single adult
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
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
Angel Palma 12/26/2006 Mother GA/USA
Felipe Leiva 05/17/2010 Mother GA/USA

Former Spouse 1 Information

Last
Leiva
First
Felipe
DOB
05/26/1976
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
No
Intake
J. Perez
Data Entry
J. Manzo
Referred By
Linea de Informacion