MAR-EDU-77

Code
MAR-EDU-77
Mercy ID
V-01918-02
Encounter Date
08/09/2005
Last
Martinez
First
Eduardo
DOB
05/21/1977
County
Dekalb
Street
2006 Regency Woods II
City
Atlanta
State
GA
Zip
30319-
Home
(404) 325-2639
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Ceja
First
Yanin
DOB
11/26/1982
Address
N/A
Telephone
(404) 325-2639
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
Angel Eduardo 08/08/2003 Parents GA/USA
Fernanda 05/19/2002 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
R. Miranda
Data Entry
K. Aleman
Referred By