MAC-POT-75

Code
MAC-POT-75
Mercy ID
V-02686-01
Encounter Date
01/15/2008
Last
Machado
First
Potira
DOB
12/19/1975
County
Fayette
Street
105 Deer Creek Ct.
City
Fairburn
State
GA
Zip
30213-
Home
(678) 517-0747
Cell
(770) 993-4581
Family Status
Single parent w/children
COB
Brazil
Gender
Female
Housing
Doubling Up
Education Level
Some College

Spouse Information

Last
Torres
First
Silvino
DOB
05/04/1973
Address
Juan A Torres Rosales AKA
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
Jorge Luis Torres 11/17/2002 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
paginas amarillas