MAC-IRM-62

Code
MAC-IRM-62
Mercy ID
V-01090-01
Encounter Date
01/16/2003
Last
Macias
First
Irma
DOB
05/28/1962
County
Fulton
Street
2942 Delowe Dr.
City
East point
State
GA
Zip
30344-
Home
(404) 559-8508
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Macias
First
Jose
DOB
01/28/1960
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
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
Angeles Guadalupe Macias 11/01/1985 Parents GA/USA
Arturo Guadalupe Macias 12/12/1990 Parents GA/USA
Gerardo Alfredo Macias 09/19/1989 Parents GA/USA
Lizeth Macias 12/02/1991 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
K. Aleman
Referred By