MOL-DEI-56

Code
MOL-DEI-56
Mercy ID
V-02889-01
Encounter Date
09/10/2008
Last
Molina
First
Deisy
DOB
10/27/1956
County
Newton
Street
670 Pinevalle Dirve
City
Covington
State
GA
Zip
30015-
Cell
(770) 883-3226
Family Status
Two parent family w/children
COB
El Salvador
Gender
Female
Housing
Single Family
Education Level
H.S. equivalency diploma

Spouse Information

Last
Martinez
First
Santos
DOB
12/23/1954
Address
N/A
Telephone
N/A
COB
Honduras
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
Melany Martinez 05/08/1996 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By
linea-Juana