MER-MAR-66

Code
MER-MAR-66
Mercy ID
V-00309-01
Encounter Date
10/11/2000
Last
Mercado
First
Martha
DOB
02/07/1966
County
Cobb
Street
Oak Street # 1746
City
Marietta
State
GA
Zip
30062-
Home
(678) 290-9443
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Rodriguez
First
Salvador
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
Erik Betancout 02/19/1986 Grandfather GA/USA
Jenny Betancout 10/13/1990 Aunt GA/USA
Victor Betancout 06/05/1988 Father 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