RAM-ANG-79

Code
RAM-ANG-79
Mercy ID
V-00862-01
Encounter Date
03/13/2002
Last
Ramos
First
Angelica
DOB
01/23/1979
County
Cobb
Street
2342 Targa Ln
City
Marietta
State
GA
Zip
30064-
Home
(770) 485-2606
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Dominguez
First
Angel
DOB
08/11/1977
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
Daniel 07/04/1999 N/A GA/USA
Marisol 11/19/2001 N/A GA/USA
Miguel Angel Dominguez 08/16/1998 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