ORT-BEA-75

Code
ORT-BEA-75
Mercy ID
V-02196-01
Encounter Date
03/14/2006
Last
Ortiz luna
First
Beatriz
DOB
02/24/1975
County
Cobb
Street
2550 Akers Mill Rd
City
Marietta
State
GA
Zip
30329-
Home
(404) 388-3272
Family Status
Two parent family w/children
COB
Dominican Rep
Gender
Female
Housing
Not Homeless
Education Level
Other

Spouse Information

Last
Feliz
First
Kelvin
DOB
05/20/1974
Address
N/A
Telephone
N/A
COB
Dominican Rep
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
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
Kelya Feliz 06/27/1998 Mother 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
Rafael Miranda