GAR-MAR-81

Code
GAR-MAR-81
Mercy ID
V-02932-01
Encounter Date
11/04/2008
Last
Garcia
First
Martha
DOB
07/25/1981
County
Rockdale
Street
1099 Plantation Blvd.
City
Conyers
State
GA
Zip
30094-
Cell
(678) 768-0402
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Aguilar
First
Marcos
DOB
04/25/1985
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
Karen Coronel 07/30/2002 Mother w/Stepfather GA/USA
Samantha Mendez 11/24/1999 Mother w/Stepfather GA/USA

Former Spouse 1 Information

Last
Mendez
First
Alfonzo
DOB
04/01/1961
Telephone
N/A
COB
N/A
Home Owner
YES
NOTES
Alfonzo Mendez vive en California

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-Griselda