MOR-MAR-76

Code
MOR-MAR-76
Mercy ID
V-03297-01
Encounter Date
04/08/2010
Last
Morales
First
Maria de la luz
DOB
06/02/1976
County
Gwinnett
Street
2684 Hewatt Rd.
City
Snellville
State
GA
Zip
30039-
Cell
(404) 781-1365
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade 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
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
Andy Ortiz 09/06/2002 Mother GA/USA
Cesar Ortiz 02/03/1996 Mother GA/USA

Former Spouse 1 Information

Last
Ortiz
First
Nicolas
DOB
05/09/1974
Telephone
N/A
COB
Mexico
Home Owner
No
NOTES

Media Authoritation

DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
J. Manzo
Referred By
linea-Juana