GAR-MIR-77

Code
GAR-MIR-77
Mercy ID
V-02763-01
Encounter Date
04/22/2008
Last
Garcia
First
Mireya
DOB
02/06/1977
County
Fulton
Street
3040 Road St.
City
East point
State
GA
Zip
30344-
Home
(404) 228-0210
Cell
(678) 789-2779
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Mendoza
First
Rodolfo
DOB
08/16/1972
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
YES
Driver
No
Home Owner
YES
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
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
Celeste Mendoza 08/17/1998 Mother GA/USA
Lisandra Mendoza 01/07/1993 Mother GA/USA
Rodolfo Mendoza 10/08/2001 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
Amiga/Laura