MAR-ALE-80

Code
MAR-ALE-80
Mercy ID
V-03081-01
Encounter Date
05/26/2009
Last
Martinez
First
Aleida
DOB
07/24/1980
County
Gwinnett
Street
1102 Lake Knoll
City
Liliburn
State
GA
Zip
30047-
Cell
(678) 789-6941
Family Status
Single adult
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
YES
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
Dasne Martinez 10/02/1997 Grandparents Mexico-maternos
Manuel Martinez 06/23/2005 Grandparents Mexico-Maternos
Mariana Martinez 08/20/1999 Grandparents Mexico-Maternos
Osmaida Martinez 08/20/1999 Grandparents Mexico-Maternos

Former Spouse 1 Information

Last
Martinez
First
Raul
DOB
06/19/1974
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-Juana