MEJ-DIN-77

Code
MEJ-DIN-77
Mercy ID
V-02484-01
Encounter Date
05/01/2007
Last
Mejia
First
Dina
DOB
06/02/1977
County
Douglass
Street
145 Chicasaw Lane
City
Austell
State
GA
Zip
30168-
Cell
(678) 683-8744
Family Status
Single parent w/children
COB
Honduras
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Arevalo
First
Oscar
DOB
08/12/1984
Address
N/A
Telephone
N/A
COB
USA
Home Owner
YES
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
Carlos Ramos 02/11/1999 Aunt GA/USA
Jose Miguel Mejia 08/22/2006 Mother GA/USA
Kaholet Mata 04/04/2001 Mother GA/USA
Katherin Mejia 12/07/2004 Mother 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
Clienta-Maris Mejia-Hna.