MAR-ROC-75

Code
MAR-ROC-75
Mercy ID
V-02322-01
Encounter Date
08/25/2006
Last
Martinez
First
Maria del rocio
DOB
06/02/1975
County
Clayton
Street
4848 Parker St
City
Forest park
State
GA
Zip
30297-
Cell
(404) 587-4295
Other
(404) 472-7912
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Vega
First
Diego
DOB
11/13/1958
Address
N/A
Telephone
(404) 472-7912
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
YES
Program Completed
YES
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
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
Beatriz Garcia 07/03/1993 Aunt GA/USA
Gloria Vega 05/18/2001 Parents GA/USA
Yasmin Martinez 07/17/2005 Parents GA/USA
Yesica Garcia 08/04/1997 Mother w/Stepfather GA/USA

Former Spouse 1 Information

Last
Garcia
First
Erasmo
DOB
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By
DFCS-Clayton