JIM-ANT-72

Code
JIM-ANT-72
Mercy ID
V-00889-01
Encounter Date
04/08/2002
Last
Jimenez ramos
First
Antonia
DOB
12/28/1972
County
Other
Street
152 Sawgrass Manor
City
Newman
State
GA
Zip
30265-
Home
(770) 251-9416
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Transitional
Education Level
Grade school

Spouse Information

Last
Bustos
First
Omar
DOB
06/10/1972
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
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Afrodita Bustos 05/05/1993 Grandmother Not Given
Antonio 09/02/1999 Grandmother Not Given
Sandy 06/13/1995 Grandmother Not Given
Victor Omar 07/13/1996 Grandmother Not Given
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