JUA-MAR-84

Code
JUA-MAR-84
Mercy ID
V-03457-01
Encounter Date
11/03/2010
Last
Juarez
First
Maria del carmen
DOB
08/01/1984
County
Dekalb
Street
3214 Valley Bluff Dr.
City
Doraville
State
GA
Zip
30340-
Cell
(404) 553-6622
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Ortiz
First
Fidel
DOB
01/20/1987
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
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
Lesly Juarez 05/24/2004 Mother w/Stepfather GA/USA
Mary Lou Juarez 07/24/2010 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-Juana