MEJ-WIL-69

Code
MEJ-WIL-69
Mercy ID
V-00464-02
Encounter Date
01/22/2008
Last
Mejia
First
Wilfredo
DOB
12/09/1969
County
Fulton
Street
4825 Northbridge Drive
City
Alpharetta
State
GA
Zip
30022-
Home
(770) 619-3272
Cell
(678) 558-4709
Family Status
Two parent family w/children
COB
Honduras
Gender
Male
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Mejia
First
Liliana
DOB
03/14/1976
Address
N/A
Telephone
(770) 619-3272
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
SOLO
No
Court Mandated
YES
Program Completed
YES
DFCS Mandated
No
Alcohol & Drug
YES
Partner Referred to Tepestri
No
Recidivism/Court
No
New Incident
No
Promesa de Confidencialidad
No
Consentimiento De Participar
YES

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
Juan David Baltazar N/A Mother w/Stepfather GA/USA
Tifany Alison Mejia N/A Parents GA/USA
Willy Joel Mejia N/A Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
J. Manzo
Referred By
Fulton Court