DYM-NAT-78

Code
DYM-NAT-78
Mercy ID
V-02895-01
Encounter Date
09/24/2008
Last
Dymant
First
Natalia
DOB
11/09/1978
County
Forsyth
Street
7125 Jonesway Road
City
Cumming
State
GA
Zip
30041-
Cell
(404) 290-9919
Family Status
Two parent family w/children
COB
Uruguay
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Dymant
First
Luis
DOB
06/20/1969
Address
N/A
Telephone
N/A
COB
USA
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
Brianna Dymant 05/05/2004 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