RAM-PAU-58

Code
RAM-PAU-58
Mercy ID
V-01487-01
Encounter Date
02/11/2004
Last
Ramirez
First
Paulina
DOB
06/22/1958
County
Cobb
Street
607 Harin Dr.
City
Marietta
State
GA
Zip
00000-0000
Home
(770) 514-0507
Family Status
Adult coupie-no children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Escobar
First
Oswaldo
DOB
06/10/1956
Address
N/A
Telephone
N/A
COB
El Salvador
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
Alma Delia Garcia N/A Adulto/Casado GA/USA
David Garcia N/A Adulto/Casado GA/USA
Edgar Garcia N/A Adulto/Casado GA/USA
Omar Garcia N/A Adulto/Casado GA/USA

Former Spouse 1 Information

Last
Garcia
First
Alejandro
DOB
06/10/1956
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
x1375 Damaryz