MEN-ANA-74

Code
MEN-ANA-74
Mercy ID
V-02973-01
Encounter Date
12/16/2008
Last
Mendoza
First
Ana
DOB
12/04/1974
County
Gwinnett
Street
2445 Beaver Ruin Road
City
Norcross
State
GA
Zip
30061-
Cell
(770) 873-0663
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Toboblanco
First
Manuel
DOB
02/28/1973
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
YES
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
Ana K. Garcia 05/30/1995 Mother GA/USA
Angel H. Abrajan 01/18/2004 Mother GA/USA
Brayan Abrajan 08/27/2000 Mother GA/USA
Fernanda Abrahan 08/23/1997 Mother GA/USA

Former Spouse 1 Information

Last
Garcia
First
David
DOB
N/A
Telephone
N/A
COB
N/A
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
J. Manzo
Referred By
linea-Juana/Periodico Mundo Hispanico