MUJ-ANG-77

Code
MUJ-ANG-77
Mercy ID
V-01425-01
Encounter Date
11/25/2003
Last
Mujica
First
Angelina
DOB
12/27/1977
County
Fulton
Street
1717 Central Village Apt A38
City
Atlanta
State
GA
Zip
30311-
Home
(678) 725-3282
Family Status
Adult coupie-no children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Arnold
First
Wesley
DOB
10/02/1966
Address
N/A
Telephone
(404) 753-6416
COB
EEUU
Home Owner
YES
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
Itza Mary Garcia 01/01/1995 Grandmother 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
K. Aleman
Referred By
x3737 Damaryz