Code
CIN-EDN-74
Mercy ID
V-02095-01
Encounter Date
10/06/2005
Last
Cintron
First
Ednny
DOB
02/18/1974
County
Dekalb
Street
2013 Gables Way
City
Atlanta
State
GA
Zip
30329-
Home
(770) 369-0645
Family Status
Two parent family w/children
COB
Puerto Rico
Gender
Female
Housing
Not Homeless
Education Level
College Degree

Spouse Information

Last
Gonzalez
First
Marco antonio
DOB
N/A
Address
N/A
Telephone
(678) 613-6040
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
DFACS County
Alcohol & Drug
No
# of DUIs
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
Driver License Date
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
Ana Maria Pertoso 07/29/1996 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
R. Gonzalez
Referred By