PER-MAH-75

Code
PER-MAH-75
Mercy ID
V-02667-01
Encounter Date
12/04/2007
Last
Peregrino
First
Martha
DOB
02/14/1975
County
Fulton
Street
206 Old Holcomb Bridge Way
City
Roswell
State
GA
Zip
30076-
Cell
(404) 399-5493
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Aguilar
First
Fernando
DOB
12/01/1973
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
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
Betsy Aguilar 07/22/2000 Aunt Mexico
Cristofer Aguilar 01/05/2004 Mother GA/USA
Maria Aguilar 08/29/1996 Mother 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