VAR-NAT-69

Code
VAR-NAT-69
Mercy ID
V-02684-01
Encounter Date
01/02/2008
Last
Vargas
First
Natalia
DOB
07/27/1969
County
Decatur
Street
1014 Yates Spring Rd.
City
Brinson
State
GA
Zip
39825-
Home
(229) 243-0384
Cell
(229) 400-7667
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Shelter
Education Level
High school graduate

Spouse Information

Last
Rivera
First
Jose
DOB
12/04/1971
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
Cynthia Rivera 07/19/2000 Mother GA/USA
Fredy Vargas 03/18/1986 Adulto/Soltero GA/USA
Jose Rivera 08/18/2002 Mother GA/USA
Lesley Rivera 10/27/2004 Mother GA/USA
Luis Vargas 01/22/1989 Mother GA/USA
Nancy Vargas 03/24/1987 Adulto/Casado 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