CAR-ROS-75

Code
CAR-ROS-75
Mercy ID
V-00439-02
Encounter Date
12/09/2003
Last
Carbajal
First
Rosendo
DOB
06/14/1975
County
Fulton
Street
603 Monterrey Pkwy
City
Atlanta
State
GA
Zip
30350-
Home
(770) 351-9468
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
Some College

Spouse Information

Last
Carbajal
First
Haydee
DOB
02/10/1977
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
YES
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
Nayeli Guadalupe 12/12/2001 Parents GA/USA
Rosendo Alexander Carbajal 10/07/2000 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
R. Miranda
Data Entry
K. Aleman
Referred By
x3737 Damaryz