CHA-MAR-63

Code
CHA-MAR-63
Mercy ID
V-00679-01
Encounter Date
09/10/2001
Last
Chamorro
First
Maria
DOB
08/08/1963
County
Cobb
Street
840 Old Alabama Rd.
City
Mableton
State
GA
Zip
30126-
Home
(770) 732-1662
Family Status
Two parent family w/children
COB
Perú
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Chamorro
First
Pele
DOB
04/30/1963
Address
N/A
Telephone
N/A
COB
Perú
Home Owner
YES
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
Clarisa 08/15/1990 Parents GA/USA
Jasmin 02/09/1994 Parents GA/USA
Yurgen 05/07/1997 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