MAR-MAR-45

Code
MAR-MAR-45
Mercy ID
V-00612-01
Encounter Date
07/25/2001
Last
Martinez
First
Marcelina
DOB
06/02/1945
County
Fulton
Street
1258-B Roberts Dr.
City
Gand park
State
GA
Zip
30315-
Home
(404) 624-4394
Family Status
Adult coupie-no children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Mejia
First
Armando
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
YES
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
Caudido N/A N/A GA/USA
Jose Mejia N/A N/A GA/USA
Juana N/A N/A GA/USA
Orlando N/A N/A GA/USA
Saturmina N/A N/A 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 Ma. Eugenia Casa San Jose