MAR-MAY-69

Code
MAR-MAY-69
Mercy ID
V-01780-01
Encounter Date
12/13/2004
Last
Martinez
First
Mayra enriqueta
DOB
09/22/1969
County
Cherokee
Street
440 Bellfarry Plain
City
Acworth
State
GA
Zip
30102-
Home
(770) 875-3267
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Villegas
First
Miguel A.
DOB
11/18/1967
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
No
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Anahi Villegas N/A N/A GA/USA
Ulises Villegas N/A N/A GA/USA
Uriel Villegas N/A N/A GA/USA
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
Damaryz 1375