MAR-MAI-70

Code
MAR-MAI-70
Mercy ID
V-03026-01
Encounter Date
03/05/2009
Last
Martinez
First
Maria luisa
DOB
03/15/1970
County
Gwinnett
Street
348 Waterbery Dr
City
Lawrenceville
State
GA
Zip
30045-
Cell
(678) 891-9393
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Martinez
First
Luis
DOB
01/18/1965
Address
N/A
Telephone
N/A
COB
Mexico
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
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
Cristian Martinez 12/12/1997 Parents GA/USA
Jasmine Martinez 12/31/2000 Parents GA/USA
Jennifer Martinez 05/14/2005 Parents GA/USA
Jesus Avila 12/30/1995 Mother w/Stepfather 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
linea-Griselda