MUÑ-TOM-70

Code
MUÑ-TOM-70
Mercy ID
V-02923-02
Encounter Date
01/26/2009
Last
Muñoz
First
Tomas
DOB
08/30/1970
County
Cobb
Street
222 Sweetwater Cir.
City
Mableton
State
GA
Zip
30126-
Cell
(404) 862-3756
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Single Family
Education Level
High school graduate

Spouse Information

Last
Ayala
First
Marisol
DOB
07/06/1970
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
Daniel Muñoz 01/14/2000 Parents GA/USA
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
Parenting class