ARB-ANA-71

Code
ARB-ANA-71
Mercy ID
V-00803-01
Encounter Date
01/04/2002
Last
Arbizu
First
Ana
DOB
12/09/1971
County
Dekalb
Street
3600 Shallowford Rd. C-4
City
Chamblee
State
GA
Zip
30341-
Home
(770) 216-1255
Family Status
Two parent family w/children
COB
Honduras
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Arbizu
First
Ventura
DOB
07/07/1953
Address
N/A
Telephone
N/A
COB
Mexico
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
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
Ana Leticia 09/06/1995 Mother w/Stepfather GA/USA
Jessenia Rocio 04/16/2001 Parents GA/USA
Karina Isabel 07/26/1999 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 Rebecca