QUI-MAR-71

Code
QUI-MAR-71
Mercy ID
V-03363-01
Encounter Date
07/14/2010
Last
Quispe
First
Maria elena
DOB
09/07/1971
County
Gwinnett
Street
5212 Down Way
City
Norcross
State
GA
Zip
30093-
Cell
(404) 519-2356
Family Status
Two parent family w/children
COB
Perú
Gender
Female
Housing
Single Family
Education Level
High school graduate

Spouse Information

Last
Ortiz
First
Arturo
DOB
02/12/1978
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
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
Jayson Ortiz 06/30/2002 Parents GA/USA
Katerine Ortiz 08/29/2003 Parents GA/USA
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
linea-Juana