GAR-BLA-73

Code
GAR-BLA-73
Mercy ID
V-03156-01
Encounter Date
09/09/2009
Last
Garcia
First
Blanca ii
DOB
04/27/1973
County
Douglass
Street
4486 Cherokee Dr. Lot 56
City
Douglasville
State
GA
Zip
30134-
Cell
(404) 483-8935
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Monroy
First
Rafael
DOB
08/18/1969
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
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
YES

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
Gissele Garcia 03/14/2002 Parents GA/USA
Judith Monroy 03/14/1998 Parents GA/USA
Katherine Monroy 06/25/1994 Parents GA/USA
Mark Monroy 09/12/1998 Parents GA/USA
NOTES

Media Authoritation

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