ALV-CAR-66

Code
ALV-CAR-66
Mercy ID
V-01173-01
Encounter Date
03/26/2003
Last
Alvarez
First
Carmen
DOB
02/15/1966
County
Fulton
Street
4586 Roswell Rd. Apt. X-3
City
Atlanta
State
GA
Zip
30342-
Home
(404) 497-0594
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Medrano
First
Juan
DOB
03/18/1971
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
YES

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
Cecilia Francisca Alvarez 01/02/1988 N/A GA/USA
Fuyata Marleni Medrano 02/21/1991 N/A GA/USA
Ivan Medrano 05/14/2000 N/A GA/USA
Sarai Medrano 09/16/2001 N/A 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