GAR-MIL-80

Code
GAR-MIL-80
Mercy ID
V-03535-01
Encounter Date
02/28/2011
Last
Garcia
First
Mildris
DOB
05/11/1980
County
Gwinnett
Street
1508 Club Parkway
City
Norcross
State
GA
Zip
30093-
Cell
(404) 751-8479
Family Status
Single adult
COB
Guatemala
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Cardenas
First
Clementino
DOB
09/29/1982
Address
N/A
Telephone
N/A
COB
Guatemala
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
Ashly Perez 11/27/2006 Father w/Stepmother GA/USA
Shalon Cardenas 10/10/2010 Parents GA/USA

Former Spouse 1 Information

Last
Perez
First
Marco tulio
DOB
N/A
Telephone
N/A
COB
Guatemala
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-Griselda