MAR-BEA-66

Code
MAR-BEA-66
Mercy ID
V-00937-01
Encounter Date
05/29/2002
Last
Martinez
First
Beatriz
DOB
11/18/1966
County
Paulding
Street
74 Cagle Way
City
Hiram
State
GA
Zip
30141-
Home
(770) 505-1595
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Other

Spouse Information

Last
Castañeda
First
Ricardo
DOB
04/05/1960
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
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
Dalia Castañeda 11/18/1983 Mother GA/USA
Jorge Castañeda N/A Mother GA/USA
Moises Castañeda N/A 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
Maria amparo Martinez/Friend