MOR-MAL-74

Code
MOR-MAL-74
Mercy ID
V-03256-01
Encounter Date
02/10/2010
Last
Mora
First
Marianeli
DOB
06/28/1974
County
Dekalb
Street
4311 North Shallowford
City
Atlanta
State
GA
Zip
30041-
Cell
(678) 252-7477
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
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
Jennifer A. Vargas 08/02/2006 Mother GA/USA
Michael A. Vargas 05/09/2002 Mother GA/USA
Ricardo Vargas 04/03/1996 Mother GA/USA

Former Spouse 1 Information

Last
Vargas
First
Mauro
DOB
01/29/1978
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
J. Perez
Data Entry
J. Manzo
Referred By