MEJ-MAR-65

Code
MEJ-MAR-65
Mercy ID
V-01427-01
Encounter Date
11/25/2003
Last
Mejia
First
Maria
DOB
03/27/1965
County
Gwinnett
Street
310 Summer Place
City
Norcross
State
GA
Zip
30071-
Home
(770) 248-9808
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
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
No
Stranger
YES

Children

NAME DOB LIVING WITH STATE/COUNTRY
Cindy Contreras 11/22/1988 Mother GA/USA
Leslie Contreras 11/23/1984 Adulto/Soltero Honduras
Marlon Contreras 11/12/1986 Mother GA/USA
Marvin Contreras 08/25/1987 Mother 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