FAL-MAR-81

Code
FAL-MAR-81
Mercy ID
V-02790-01
Encounter Date
05/19/2008
Last
Falcon
First
Maritza
DOB
12/30/1981
County
Gwinnett
Street
3171 Terrace Court
City
Norcross
State
GA
Zip
30092-
Cell
(678) 755-8723
Family Status
Two parent family w/children
COB
Uruguay
Gender
Female
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Tapia
First
Francisco
DOB
03/20/1978
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
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
Justin Florin 08/21/2003 Mother GA/USA

Former Spouse 1 Information

Last
Florin
First
Alfredo
DOB
11/10/1975
Telephone
N/A
COB
Uruguay
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
C. Martinez
Referred By
linea