MON-MAR-68

Code
MON-MAR-68
Mercy ID
V-00355-01
Encounter Date
11/28/2000
Last
Montes
First
Marta
DOB
01/26/1968
County
Dekalb
Street
3866 waterroak way
City
Doraville
State
GA
Zip
30341-
Home
(770) 416-1735
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Gonzalez
First
Abel
DOB
12/14/1970
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
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
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
edgar gonzalez 09/04/1993 Parents GA/USA
lizbeth gonzalez 05/18/1995 Parents GA/USA
NOTES
Formely was known as Portil Marta

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
S. Aviña
Referred By
guadalupe montez (ex-clienta)