NUÑ-ADR-70

Code
NUÑ-ADR-70
Mercy ID
V-03322-01
Encounter Date
05/05/2010
Last
Nuñez
First
Adriana
DOB
09/16/1970
County
Clayton
Street
976 Forest Ave. D-42
City
Forest park
State
GA
Zip
30297-
Cell
(404) 748-2831
Family Status
Single adult
COB
Mexico
Gender
Female
Housing
Single Family
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
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
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
Jose I Lustre Nuñez 08/02/2002 DFACS Clayton
Michell Faz 09/16/2006 DFACS Clayton

Former Spouse 1 Information

Last
Faz torres
First
Epifanio
DOB
04/28/1980
Telephone
N/A
COB
Mexico
Home Owner
YES
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
YES
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By