AGU-SUS-82

Code
AGU-SUS-82
Mercy ID
V-01937-01
Encounter Date
06/22/2005
Last
Aguirre
First
Susana
DOB
03/10/1982
County
Fulton
Street
Not given
City
Atlanta
State
GA
Zip
00000-000
Home
(404) 853-5130
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Shelter
Education Level
High school graduate

Spouse Information

Last
Correa
First
Juan
DOB
N/A
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
Brandon Correa Aguirre 05/22/2005 Mother GA/USA
Wilbert Alexander Aguirre 04/15/2003 Mother GA/USA
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