MAR-ANA-55

Code
MAR-ANA-55
Mercy ID
V-01969-01
Encounter Date
07/06/2005
Last
Martinez
First
Ana maria
DOB
04/03/1955
County
Dekalb
Street
306 Plaseandale
City
Doraville
State
GA
Zip
30340-
Cell
(404) 399-7160
Family Status
Single adult
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Preschool

Spouse Information

Last
Salazar
First
Luis
DOB
02/25/1950
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
YES
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
YES
Consentimiento De Participar
YES

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
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Adan Salazar N/A N/A GA/USA
Cristian Salazar Martinez 10/04/1990 Mother GA/USA
Eva Maria Salazar N/A N/A GA/USA
Fernando Salazar N/A N/A GA/USA
Flavio Cesar Salazar N/A Adulto/Casado GA/USA
Juan Diego Salazar 11/12/1991 Mother GA/USA
Marcos Luis Salazar N/A Adulto/Casado GA/USA
Maria de la Luz Salazar N/A Adulto/Casado GA/USA
Omar Salazar N/A Adulto/Casado GA/USA
Roman Salazar 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
G. Landeros
Data Entry
K. Aleman
Referred By