MIR-JOS-75

Code
MIR-JOS-75
Mercy ID
V-02778-02
Encounter Date
05/13/2008
Last
Miranda
First
Jose
DOB
02/14/1975
County
Fulton
Street
597 Eagles Crest Village lane 2
City
Roswell
State
GA
Zip
30076-
Cell
(678) 531-8027
Family Status
Two parent family w/children
COB
Honduras
Gender
Male
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Manzanares
First
Marlin
DOB
12/25/1976
Address
N/A
Telephone
N/A
COB
Honduras
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
YES
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
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
Emily Juliette Miranda 07/10/2007 Parents GA/USA
Jose Armando Miranda 03/27/1998 Grandparents Honduras-Paternos
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
court-Fulton