MAR-JOV-74

Code
MAR-JOV-74
Mercy ID
V-01371-01
Encounter Date
10/10/2003
Last
Martinez
First
Jovita
DOB
11/28/1974
County
Dekalb
Street
1140 Park Creek Circle
City
Lawrenceville
State
GA
Zip
30044-
Home
(770) 921-4839
Cell
(404) 805-1329
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Areano
First
Rolando
DOB
02/03/1961
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
Ailine Martinez 12/18/1999 Mother GA/USA
Gustavo Paredes 07/23/1993 Mother GA/USA
Mia Martinez 06/21/2003 Mother GA/USA
Michael Cortes 02/28/1992 Mother GA/USA

Former Spouse 1 Information

Last
Arenas
First
Armando
DOB
03/03/1968
Telephone
N/A
COB
N/A
Home Owner
No
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