ORT-MAR-73

Code
ORT-MAR-73
Mercy ID
V-00191-01
Encounter Date
04/26/2000
Last
Ortiz
First
Margarita
DOB
09/17/1973
County
Gwinnett
Street
5881 park Rd
City
Doraville
State
GA
Zip
30340-
Home
(770) 441-5865
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Ortiz
First
Evidio
DOB
05/06/1959
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
Eunnice Viridiana 08/28/1987 Parents GA/USA
Oscar 01/09/1983 Parents GA/USA
Vianey Alejandra 11/14/1984 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
D. Gomez
Referred By