MAR-ISA-83

Code
MAR-ISA-83
Mercy ID
V-02266-01
Encounter Date
06/09/2006
Last
Martines
First
Isabel
DOB
05/13/1983
County
Other
Street
1512 Hwy 85 West #45A
City
Fayetteville
State
GA
Zip
30240-
Cell
(770) 719-3924
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Other
Education Level
High school graduate

Spouse Information

Last
Campos
First
Genaro
DOB
N/A
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
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
Kelvin Campos 09/28/2001 Parents GA/USA
Ricardo Campos 05/21/2004 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