HUR-MAR-85

Code
HUR-MAR-85
Mercy ID
V-00863-01
Encounter Date
03/13/2002
Last
Hurtado
First
Maribel
DOB
02/28/1985
County
Cobb
Street
861 Franklin Rd. Apt. 196
City
Marietta
State
GA
Zip
30067-
Home
(678) 797-0308
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Serrano
First
Fernando
DOB
11/18/1982
Address
256-A Hood Parkway Kennesaw Ga. 30041
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
YES
Consentimiento De Participar
YES

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
Fernando Edgar Serrano 08/31/2001 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