RAD-MAR-75

Code
RAD-MAR-75
Mercy ID
V-00286-01
Encounter Date
09/19/2000
Last
Radilla
First
Maria
DOB
02/12/1975
County
Dekalb
Street
6452 Elrod St.
City
Doraville
State
GA
Zip
30340-
Home
(770) 446-7484
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Moreno
First
Jose
DOB
01/25/1975
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
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
Adolfo Moreno 03/15/1999 Mother GA/USA
Jose Bryan Radilla 11/17/2000 Mother GA/USA
Rodolfo Moreno 01/21/1995 Mother 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
Y. Garcia
Referred By
Walk-In