PAD-MAR-55

Code
PAD-MAR-55
Mercy ID
V-01779-01
Encounter Date
12/13/2004
Last
Padua
First
Maria yamileth
DOB
12/12/1955
County
Gwinnett
Street
5068 Burn Oak Rd NW
City
Lilburn
State
GA
Zip
30047-
Cell
(678) 914-3952
Family Status
Single adult
COB
Colombia
Gender
Female
Housing
Doubling Up
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
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
YES
Consentimiento De Participar
YES

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

TPO
No
Stay Away Condition
No
Mutual
No
Driver
No
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No

Former Spouse 1 Information

Last
Mesique
First
Pablo
DOB
11/19/1962
Telephone
N/A
COB
Uruguay
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
K. Aleman
Referred By
Carolina Martinez