MIR-EST-76

Code
MIR-EST-76
Mercy ID
V-02584-02
Encounter Date
09/11/2007
Last
Miralrio
First
Esteban
DOB
08/04/1976
County
Fulton
Street
5320 Roswell Rd. N.E. Apt. O-1
City
Atlanta
State
GA
Zip
30342-
Cell
(404) 453-2421
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Not Homeless
Education Level
High school graduate

Spouse Information

Last
Villanueva
First
Gabriela
DOB
12/21/1980
Address
N/A
Telephone
(404) 257-3310
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
YES
Program Completed
YES
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
Paula Atzalea Miralrio 01/21/2007 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
Fulton Court