CAR-BEI-76

Code
CAR-BEI-76
Mercy ID
V-02270-01
Encounter Date
06/13/2006
Last
Carranza
First
Beisy
DOB
02/26/1976
County
Gwinnett
Street
659 South Wind Dr
City
Lilburn
State
GA
Zip
30047-
Home
(678) 665-5168
Other
(770) 256-8200
Family Status
Two parent family w/children
COB
Honduras
Gender
Female
Housing
Doubling Up
Education Level
Other

Spouse Information

Last
Martinez
First
William
DOB
08/25/1973
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
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
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Ilda Martinez 11/28/1995 Parents GA/USA
Kenly Carranza (niece) 09/18/1994 Aunt GA/USA
William Martinez Jr 09/27/2000 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