MAR-ANA-75

Code
MAR-ANA-75
Mercy ID
V-02304-01
Encounter Date
08/21/2006
Last
Martinez
First
Ana cecilia
DOB
04/04/1975
County
Dekalb
Street
4123 Winsor Oak
City
Doraville
State
GA
Zip
30340-
Home
(770) 242-2577
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Aguilar
First
Alfonso
DOB
11/23/1966
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
YES

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
Alfonso Aguilar 03/20/2000 Parents GA/USA
Jaretzy Aguilar 06/01/2006 Parents GA/USA
Oscar Aguilar 01/18/2005 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
J. Manzo
Referred By