MAR-ILE-72

Code
MAR-ILE-72
Mercy ID
V-02223-01
Encounter Date
04/14/2006
Last
Martinez
First
Ileana
DOB
04/19/1972
County
Gwinnett
Street
5105 West Circle
City
Lilburn
State
GA
Zip
30047-
Home
(678) 598-7362
Family Status
Two parent family w/children
COB
Uruguay
Gender
Female
Housing
Not Homeless
Education Level
H.S. equivalency diploma

Spouse Information

Last
Cisnernos
First
Gustavo
DOB
N/A
Address
N/A
Telephone
N/A
COB
Uruguay
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
Maria Eugenia Cisneros 10/10/1998 Parents GA/USA
Rodrigo Cisnernos 02/23/2005 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