RET-FRA-79

Code
RET-FRA-79
Mercy ID
V-03403-01
Encounter Date
08/26/2010
Last
Reyes
First
Francisca
DOB
07/14/1979
County
Gwinnett
Street
5343 Coventry
City
Norcross
State
GA
Zip
30071-
Cell
(404) 838-3294
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
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
Christian Ramos 04/29/2005 Mother GA/USA
Cristal Ramos 04/29/2005 Mother GA/USA
Lesly Ramos 03/13/2002 Mother GA/USA
Ricardo Ramos 06/28/2003 Mother GA/USA

Former Spouse 1 Information

Last
Ramos
First
Cristino
DOB
07/25/1978
Telephone
N/A
COB
Mexico
Home Owner
No
NOTES

Media Authoritation

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