MAR-ANG-84

Code
MAR-ANG-84
Mercy ID
V-02550-01
Encounter Date
07/23/2007
Last
Martines
First
Angelica maria
DOB
12/16/1984
County
Gwinnett
Street
2017 Rockridge Ct. # G-34
City
Norcross
State
GA
Zip
30093-
Home
(678) 598-2073
Family Status
Two parent family w/children
COB
El Salvador
Gender
Female
Housing
Not Homeless
Education Level
Adult, no formal education

Spouse Information

Last
Mancillas
First
Carlos
DOB
N/A
Address
N/A
Telephone
N/A
COB
El Salvador
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
No
Consentimiento De Participar
No

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
Carlos A. Martines 05/21/2006 Parents GA/USA
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
Carmen Pellicer