GAR-OTI-73

Code
GAR-OTI-73
Mercy ID
V-01384-01
Encounter Date
10/20/2003
Last
Garcia
First
Otilia
DOB
03/02/1973
County
Fulton
Street
849 Park Ridge Circle Apt. G
City
Roswell
State
GA
Zip
30076-
Home
(770) 992-2866
Cell
(678) 622-1357
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
N/A
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
Aaron Santillano 04/11/1996 Mother GA/USA
Alvaro Santillano 12/17/1991 Mother GA/USA
Edgar Santillano 01/22/1999 Mother GA/USA
Jason Santillano 12/13/1993 Mother GA/USA
Luis Santillano 05/02/1990 Mother GA/USA

Former Spouse 1 Information

Last
Santillan
First
Alfredo
DOB
05/29/1972
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
x3737 Damaryz