MEJ-MAN-72

Code
MEJ-MAN-72
Mercy ID
V-02414-02
Encounter Date
03/06/2007
Last
Mejia
First
Manuel
DOB
09/06/1972
County
Dekalb
Street
2555 Pilgrim Way NE Apt.-B
City
Atlanta
State
GA
Zip
30345-
Cell
(678) 768-8614
Family Status
Two parent family w/children
COB
Honduras
Gender
Male
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Padilla
First
Lilian
DOB
03/12/1983
Address
N/A
Telephone
(678) 927-5073
COB
Honduras
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
YES
Program Completed
No
DFCS Mandated
No
Alcohol & Drug
YES
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
Cathy Jaciela Padilla 11/08/2004 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
J. Manzo
Referred By
Dekalb Court