MEN-MAR-76

Code
MEN-MAR-76
Mercy ID
V-00935-01
Encounter Date
05/30/2002
Last
Mendez
First
Margarita
DOB
09/14/1976
County
Gwinnett
Street
2825 Hamilshak Dr.
City
Bufford
State
GA
Zip
30519-
Home
(770) 271-1617
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Mendez
First
Ismael
DOB
06/17/1968
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
YES
Consentimiento De Participar
YES

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
Daphne 01/22/1997 Parents GA/USA
Daysi 10/08/1998 Parents GA/USA
Tanya 10/24/1992 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