VAR-IRI-76

Code
VAR-IRI-76
Mercy ID
V-03348-01
Encounter Date
06/21/2010
Last
Vargas
First
Iris
DOB
10/10/1976
County
Fulton
Street
11 Sweetberry Cr.
City
Alpharetta
State
GA
Zip
30005-
Cell
(404) 587-8863
Family Status
Single parent w/children
COB
Colombia
Gender
Female
Housing
Single Family
Education Level
College Degree

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
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
Esra Alarah 06/16/2004 Mother GA/USA
Mirian Alarah 10/10/2007 Mother GA/USA
Sarah Alarah 07/01/2006 Mother GA/USA

Former Spouse 1 Information

Last
Alarah
First
Hytam
DOB
N/A
Telephone
N/A
COB
Jordania
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
linea-Juana