MAR-ANG-80

Code
MAR-ANG-80
Mercy ID
V-01983-01
Encounter Date
08/23/2005
Last
Martinez
First
Angelica
DOB
06/28/1980
County
Dekalb
Street
3707 Shallowford Road Apt. H
City
Doraville
State
GA
Zip
30340-
Cell
(678) 887-8438
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Ramos
First
Cruz
DOB
11/03/1976
Address
N/A
Telephone
N/A
COB
Guatemala
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
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
Alma Veronica Zuñiga 02/02/1998 Mother w/Stepfather GA/USA
Andres Ramos 08/25/2006 Parents GA/USA
Jenifer Zuñiga 08/27/1999 Mother w/Stepfather GA/USA

Former Spouse 1 Information

Last
Zuñiga
First
Isabel
DOB
11/03/1976
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. Perez
Data Entry
K. Aleman
Referred By