MAR-LUI-69

Code
MAR-LUI-69
Mercy ID
V-02225-01
Encounter Date
04/19/2006
Last
Martniez
First
Luisa margarita
DOB
12/23/1969
County
Fulton
Street
1910 Phillips Avenue Apt. 4-D
City
East point
State
GA
Zip
30344-
Home
(404) 763-1425
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Mata cunizales
First
Julian
DOB
01/09/1969
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
Fatima Cecilia Mata 04/05/1991 Parents GA/USA
Jessica Mata 09/23/2004 Parents GA/USA
Luis A. Mata M. 08/06/1992 Parents 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
Fulton Court