NAV-ANA-07

Code
NAV-ANA-07
Mercy ID
V-03490-01
Encounter Date
12/23/2010
Last
Navarro
First
Ana maria
DOB
07/26/1979
County
Colquitt
Street
514 1st. Street South West
City
Moultrie
State
GA
Zip
30176-8
Cell
(229) 296-4532
Family Status
Single parent w/children
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
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
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Ana N. Salas 01/06/2000 Father Houston
Brain Navarro 12/14/1997 Father Houston
Isabel M Rogers 12/29/2004 Father Arizona
Natalie Navarro 09/06/2003 Mother GA/USA

Former Spouse 1 Information

Last
Wellons
First
Wesley
DOB
07/19/1973
Telephone
N/A
COB
USA
Home Owner
No
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