MAY-PAT-77

Code
MAY-PAT-77
Mercy ID
V-01236-01
Encounter Date
05/20/2003
Last
Mayorga
First
Patricia
DOB
06/22/1977
County
Cobb
Street
22 Lambeth Dr.
City
Hiram
State
GA
Zip
30141-
Home
(770) 949-0087
Family Status
Adult coupie-no children
COB
Nicaragua
Gender
Female
Housing
Not Homeless
Education Level
Some College

Spouse Information

Last
Aguilar
First
Jose
DOB
03/13/1971
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
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
Alan Godea 02/26/2000 Aunt Nicaragua
Stephanie Lopez 01/14/1989 Father Nicaragua
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