NAM-MON-69

Code
NAM-MON-69
Mercy ID
V-00570-01
Encounter Date
05/23/2001
Last
Nambo
First
Monica
DOB
04/22/1969
County
Clayton
Street
1084 Stoney Brook Rd.
City
Forest park
State
GA
Zip
30297-
Home
(404) 361-8303
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Aguirre
First
Felipe
DOB
08/04/1968
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
Jose Carmen 06/09/1992 Parents GA/USA
Juan 03/12/1989 Parents GA/USA
Liliana 10/15/1990 Parents GA/USA
Maria Aurora 06/17/1998 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
K. Aleman
Referred By
x7764 Michael Roman