RAM-MAR-77

Code
RAM-MAR-77
Mercy ID
V-02523-01
Encounter Date
02/27/2008
Last
Ramirez
First
Maria juana
DOB
07/09/1977
County
Clayton
Street
4726 Barenett Road
City
Forest park
State
GA
Zip
30297-
Cell
(678) 984-7852
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
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
YES
Clayton
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
Jazmin Santiago 06/12/2002 Mother GA/USA
Maria de Jesus Santiago 12/25/1997 Mother GA/USA
Maria Santiago 06/18/1995 Mother GA/USA
Marlen Santiago 03/07/2001 Mother GA/USA

Former Spouse 1 Information

Last
Santiago
First
Jose
DOB
09/29/1977
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
Juana/DFCS