POR-MAR-60

Code
POR-MAR-60
Mercy ID
V-00861-01
Encounter Date
03/05/2002
Last
Porra
First
Marta
DOB
06/14/1960
County
Gwinnett
Street
2500 Pleseant Hill Rd. Apt. 1018
City
Duluth
State
GA
Zip
30069-
Home
(678) 475-0250
Cell
(678) 584-9889
Family Status
Two parent family w/children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
High school graduate

Spouse Information

Last
Valentin
First
Jose
DOB
09/28/1959
Address
N/A
Telephone
N/A
COB
Puerto Rico
Home Owner
No
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
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Andres Felipe N/A Mother w/Stepfather GA/USA
Jose Alejandro N/A Parents GA/USA
Omar Alejandro N/A Parents GA/USA
Samuel Alejandro N/A Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
K. Aleman
Referred By
x7764 Ma. Eugenia