DIA-MAR-72

Code
DIA-MAR-72
Mercy ID
V-01269-01
Encounter Date
06/27/2003
Last
Diaz
First
Marina
DOB
03/02/1972
County
Dekalb
Street
3137 Mosoe
City
Doraville
State
GA
Zip
30341-
Home
(770) 374-7326
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Mendoza
First
Angel
DOB
N/A
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
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
Dulcina Bravo Diaz 09/03/1990 Grandmother Guatemala
Enelma Bravo Diaz 10/08/1995 Grandmother Guatemala
Fachely Bravo Diaz 02/07/1993 Grandmother Guatemala
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
Partner