GAR-MAR-49

Code
GAR-MAR-49
Mercy ID
V-02058-01
Encounter Date
10/06/2005
Last
Garcia
First
Maria ninfa
DOB
11/21/1949
County
Gwinnett
Street
1131 Diekends Rd
City
Lilburn
State
GA
Zip
30047-
Home
(404) 608-0801
Cell
(404) 862-2850
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Other

Spouse Information

Last
N/A
First
Roberto
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
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
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
Marisol Partida N/A Mother GA/USA
Roberto Partida N/A Mother GA/USA
Ximena Partida N/A 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
R. Gonzalez
Referred By