MAT-FEL-60

Code
MAT-FEL-60
Mercy ID
V-00400-01
Encounter Date
01/26/2001
Last
Mata
First
Felisa
DOB
11/20/1960
County
Dekalb
Street
478 pine dr. p.o. box 163
City
Pine lake
State
GA
Zip
30072-
Home
(404) 299-3865
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Mata
First
Arturo
DOB
06/10/1957
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
YES
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
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
aelisa mata 12/17/1984 Mother GA/USA
ariana mata 12/17/1985 Mother GA/USA
arturo mata 12/23/1989 Mother GA/USA
edith mata 08/14/1980 Adulto/Casado GA/USA
luis mata 01/22/1984 Mother GA/USA
salvador mata 06/08/1993 Mother GA/USA
tiburcio mata 06/08/1987 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
S. Aviña
Referred By
casa san jose