VIC-MAR-57

Code
VIC-MAR-57
Mercy ID
V-00029-02
Encounter Date
02/02/2000
Last
Vicente
First
Margarito
DOB
07/20/1957
County
Cherokee
Street
310 Keith Dr Lote 7
City
Lanton
State
GA
Zip
30114-
Family Status
Adult coupie-no children
COB
Guatemala
Gender
Male
Housing
Not Homeless
Education Level
Preschool

Spouse Information

Last
Matias
First
Maria
DOB
01/27/1969
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
SOLO
No
Court Mandated
No
Program Completed
YES
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
Brenda Tefany Vicente 07/05/1995 Parents GA/USA
Luis Angel Vicente 07/06/1997 Parents GA/USA
Maria Elena Vicente 06/02/1998 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
R. Miranda
Data Entry
D. Gomez
Referred By