PER-MAT-79

Code
PER-MAT-79
Mercy ID
V-02551-01
Encounter Date
07/25/2007
Last
Perez
First
Matilde
DOB
03/14/1979
County
Cobb
Street
546 Benmark Ct.
City
Smyrna
State
GA
Zip
30080-
Cell
(770) 895-0023
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Maldonado
First
Rodrigo
DOB
03/13/1977
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
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
David Maldonado 03/11/2000 Parents GA/USA
Lisandro Maldonado 01/20/2002 Parents GA/USA
Milton Maldonado 05/02/2006 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
linea-Juana