ALT-PAB-77

Code
ALT-PAB-77
Mercy ID
V-02687-02
Encounter Date
01/15/2008
Last
Altamirano
First
Pablo
DOB
11/18/1977
County
Gwinnett
Street
1780 Graves Road # 1110
City
Norcross
State
GA
Zip
30093-
Cell
(678) 392-6241
Family Status
Single adult
COB
Mexico
Gender
Male
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Rueda
First
Viridiana
DOB
03/09/1985
Address
N/A
Telephone
(678) 913-7141
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
YES
Program Completed
No
DFCS Mandated
No
Alcohol & Drug
YES
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
Beatriz Altamirano 12/14/1999 Mother GA/USA
Melisa Altamirano 02/12/2007 Mother GA/USA
Paola Altamirano 11/28/2001 Mother GA/USA
Vanesa Altamirano 12/15/2003 Mother 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