SIM-MAR-51

Code
SIM-MAR-51
Mercy ID
V-00580-01
Encounter Date
06/27/2001
Last
Simmons
First
Marina
DOB
12/16/1951
County
Cobb
Street
3892 Mulkey Circle
City
Marietta
State
GA
Zip
30008-
Home
(770) 745-8980
Family Status
Single parent w/children
COB
Venezuela
Gender
Female
Housing
Not Homeless
Education Level
Post Grad Degree

Spouse Information

Last
Simmons
First
Leonard
DOB
09/10/1957
Address
N/A
Telephone
N/A
COB
EEUU
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
Naehobe Gonzalez 03/09/1987 Mother 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 Evita Morales