PER-FAT-86

Code
PER-FAT-86
Mercy ID
V-02599-01
Encounter Date
09/24/2007
Last
Perez
First
Fatima
DOB
01/07/1986
County
Hall
Street
1750 Norton Dr. Apt. I-9
City
Gainsville
State
GA
Zip
30501-
Cell
(404) 839-8897
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Perez
First
Baltazar
DOB
11/06/1977
Address
N/A
Telephone
N/A
COB
Mexico
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
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
Bridget Perez 02/07/2005 Mother GA/USA
Katherin 11/06/2006 Mother GA/USA
Melani Perez 12/16/2003 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