ART-GAB-70

Code
ART-GAB-70
Mercy ID
V-02688-01
Encounter Date
01/18/2008
Last
Artiaga
First
Gabriela
DOB
03/29/1970
County
Clayton
Street
905 White Oak Trail
City
Jonesboro
State
GA
Zip
30238-
Cell
(404) 552-4106
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Lopez
First
Julio cesar
DOB
03/05/1981
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
YES
Consentimiento De Participar
YES

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
Alexandra Cisneros 11/15/1996 Mother GA/USA
Jonathan Cisneros 03/10/1995 Mother GA/USA
Juan Cisneros 12/29/1988 Mother GA/USA

Former Spouse 1 Information

Last
Cisneros
First
Juan
DOB
08/28/1965
Telephone
N/A
COB
Mexico
Home Owner
No
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
clienta