NUÑ-MAR-81

Code
NUÑ-MAR-81
Mercy ID
V-03510-01
Encounter Date
01/25/2011
Last
Nuñez
First
Martha
DOB
02/09/1981
County
Fulton
Street
2400 Riverwood Lane
City
Roswell
State
GA
Zip
30075-
Cell
(404) 447-8167
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high 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
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
Katherine Santana 08/22/2007 Mother GA/USA
Neidith Santana 06/11/1996 Mother GA/USA
Yasimi Santana 01/13/2003 Mother GA/USA
Yuritzi Santana 10/10/1999 Mother GA/USA

Former Spouse 1 Information

Last
Santana
First
Uraldo
DOB
05/16/1977
Telephone
N/A
COB
Mexico
Home Owner
No
NOTES

Media Authoritation

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/Grady