MAR-ANG-74

Code
MAR-ANG-74
Mercy ID
V-02024-01
Encounter Date
09/13/2005
Last
Marcos
First
Angelina
DOB
07/16/1974
County
Fulton
Street
201 Northwood
City
Atlanta
State
GA
Zip
30342-
Home
(678) 608-8744
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Mendoza
First
Alberto
DOB
05/11/1982
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
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Bianeth Rafael 07/29/2002 Mother GA/USA
Erwin Rafael 06/24/2000 Mother GA/USA
Jim Abner Rafael 04/04/2004 Mother GA/USA
Jonathan Rafael N/A Grandmother GA/USA
Magaly Rafael 12/07/1993 Grandmother GA/USA
Raymundo Rafael 06/04/1992 Father 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