MON-JOS-85

Code
MON-JOS-85
Mercy ID
V-03347-01
Encounter Date
06/18/2010
Last
Montez
First
Josefina
DOB
10/05/1985
County
Dekalb
Street
5160 Buford Hwy. # 18-B
City
Chamblee
State
GA
Zip
30341-
Cell
(404) 275-2857
Family Status
Two parent family w/children
COB
El Salvador
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Monserratos
First
Angel antonio
DOB
04/07/1980
Address
N/A
Telephone
N/A
COB
El Salvador
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
Humberto A. Montez 09/18/2002 Mother w/Stepfather GA/USA
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-Griselda