MAR-MAR-86

Code
MAR-MAR-86
Mercy ID
V-02990-01
Encounter Date
01/23/2009
Last
Martinez
First
Maria de los angeles
DOB
07/31/1986
County
Dekalb
Street
6658 Peachtree Ind. Blvd. # D
City
Doraville
State
GA
Zip
30360-
Cell
(404) 938-6539
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Nevares
First
Luis
DOB
03/05/1983
Address
N/A
Telephone
N/A
COB
USA
Home Owner
YES
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
Bryan Martinez 12/24/2008 Mother GA/USA
Gilbert Rodriguez 10/28/2002 Mother GA/USA
Luis Martinez 09/01/2005 Mother 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
walkin -Felipe