MAR-ANA-81

Code
MAR-ANA-81
Mercy ID
V-03009-01
Encounter Date
02/17/2009
Last
Martinez
First
Ana laura
DOB
12/06/1981
County
Dekalb
Street
3536 Pleasantbrook Village # B
City
Doraville
State
GA
Zip
30340-
Cell
(678) 368-5738
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
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
Brenda L. Alberto 06/11/1999 Mother GA/USA
Gabriel Alberto 06/10/2003 Mother GA/USA
Sumiko N. Alberto 03/27/2001 Mother GA/USA

Former Spouse 1 Information

Last
Alberto
First
Cesar
DOB
03/06/1977
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
G. Landeros
Data Entry
J. Manzo
Referred By
linea-Griselda