MON-MAR-58

Code
MON-MAR-58
Mercy ID
V-00055-01
Encounter Date
02/01/2000
Last
Montenegro
First
Maria elena
DOB
05/24/1958
County
Dekalb
Street
3061 Oakcliff Rd Apt-41
City
Doraville
State
GA
Zip
30340-
Home
(770) 451-2622
Family Status
Single adult
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
College Degree

Spouse Information

Last
Celis
First
Ivan
DOB
04/27/1958
Address
N/A
Telephone
N/A
COB
Colombia
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
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
Andrus Celis 02/10/1993 Mother GA/USA
Ivan Alexande Celis 12/23/1991 Mother GA/USA
Nicole Celis 09/20/1994 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
D. Gomez
Referred By