VER-MAR-61

Code
VER-MAR-61
Mercy ID
V-00585-01
Encounter Date
06/28/2001
Last
Vera
First
Maria
DOB
08/28/1961
County
Clayton
Street
1406 Buckingham Dr.
City
Hampton
State
GA
Zip
30228-
Home
(770) 477-7669
Family Status
Two parent family w/children
COB
Puerto Rico
Gender
Female
Housing
Not Homeless

Spouse Information

Last
Vera
First
Martin
DOB
07/29/1959
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
YES
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
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
Josue Vera 10/23/1979 Parents GA/USA
Nadia 08/02/1984 Parents GA/USA
Sorimar 07/14/1987 Parents 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
K. Aleman
Referred By
x7764 Michelle Roman