PIM-VAL-58

Code
PIM-VAL-58
Mercy ID
V-00250-01
Encounter Date
07/19/2000
Last
Pimentel
First
Valentina
DOB
07/21/1958
County
Dekalb
Street
1225 Kelton Dr
City
Stone mountain
State
GA
Zip
30383-
Home
(404) 296-3270
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Moreno
First
Manuel
DOB
10/18/1956
Address
N/A
Telephone
N/A
COB
España
Home Owner
No
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
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
Irma Genedith Garcia 08/23/1977 Father GA/USA
Steven manuel Moreno 01/30/1988 Father GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
D. Gomez
Referred By