VIL-PAU-69

Code
VIL-PAU-69
Mercy ID
V-03386-01
Encounter Date
07/29/2010
Last
Villasana
First
Paula
DOB
03/02/1969
County
Fulton
Street
201 Northwood Dr. # 66
City
Sandy springs
State
GA
Zip
30342-
Cell
(678) 668-6812
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
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
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
Cindy Perez 04/24/1994 Mother GA/USA
Cristian Perez 11/26/1997 Mother GA/USA
Leonel Perez 12/06/1998 Mother GA/USA

Former Spouse 1 Information

Last
Hernandez
First
Gerardo
DOB
03/23/1962
Telephone
N/A
COB
Mexico
Home Owner
YES
NOTES

Media Authoritation

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