MUÑ-ROS-65

Code
MUÑ-ROS-65
Mercy ID
V-02009-01
Encounter Date
09/06/2005
Last
Muñoz
First
Rosa maria
DOB
08/26/1965
County
Other
Street
415 North Side Dr. Apt A-2
City
Valdosta
State
GA
Zip
31602-
Home
(229) 630-7416
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Avellaneda
First
Samuel
DOB
08/20/1953
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
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
Cesar E. Araiza 03/01/1988 Mother GA/USA
Karla Araiza 05/10/1992 Mother GA/USA
Oscar D. Araiza 05/26/1989 Mother GA/USA
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
x1375 Damaryz