MAN-VIC-83

Code
MAN-VIC-83
Mercy ID
V-01802-01
Encounter Date
01/10/2005
Last
Mantilla
First
Victoria
DOB
12/13/1983
County
Fulton
Street
5559 Glenridge Dr. Apt 1410
City
Atlanta
State
GA
Zip
30342-
Cell
(404) 274-1061
Family Status
Single adult
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Some College

Spouse Information

Last
Calben
First
John
DOB
02/13/1980
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

Former Spouse 1 Information

Last
Falto
First
Santiago
DOB
04/09/1982
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
Damaryz