MAR-PED-73

Code
MAR-PED-73
Mercy ID
V-01970-02
Encounter Date
07/19/2005
Last
Martinez
First
Pedro
DOB
09/08/1973
County
Dekalb
Street
3179 Shadow Walk Ln.
City
Tucker
State
GA
Zip
30084-
Home
(404) 867-4630
Work
(678) 508-1568
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Espino
First
Maria
DOB
10/07/1970
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
YES
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
Alicia Garcia N/A N/A GA/USA
Jorge Garcia 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
R. Miranda
Data Entry
K. Aleman
Referred By