MUÑ-NAT-61

Code
MUÑ-NAT-61
Mercy ID
V-01767-01
Encounter Date
11/29/2004
Last
Muñoz
First
Natividad
DOB
12/15/1961
County
Cobb
Street
1901 Old Concord Rd.
City
Smyrna
State
GA
Zip
30080-
Home
(770) 438-7875
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Ramirez
First
Jaime
DOB
04/21/1965
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
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
Fatima Ramirez 08/31/2000 Parents GA/USA
Jose Jaime Ramirez 09/09/1987 Parents GA/USA
Juan Carlos Ramirez 12/01/1989 Parents GA/USA
Karla Ramirez 05/09/1995 Parents GA/USA
Lupita Ramirez 02/01/2004 Parents GA/USA
Maria Guadalupe Ramirez 04/04/1986 Deceased GA/USA
Nancy Ramirez 08/05/1990 Parents GA/USA
NOTES
Older daughter died of heart disease

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
Clinica y Damaryz