ORT-MAR-72

Code
ORT-MAR-72
Mercy ID
V-00272-01
Encounter Date
08/28/2000
Last
Ortiz
First
Maria del carmen
DOB
08/25/1972
County
Cobb
Street
1019 Franklin Rd #20-A
City
Marietta
State
GA
Zip
30067-
Home
(770) 424-0973
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
College Degree

Spouse Information

Last
Dunbar
First
Terry
DOB
05/27/1963
Address
2550 Cumberland Blv. Smyrna GA 30080
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
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
Terry Jasmin Dunbar 07/19/1998 Mother GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
D. Gomez
Referred By
Legal Aid