AYA-GAB-70

Code
AYA-GAB-70
Mercy ID
V-01181-01
Encounter Date
04/02/2003
Last
Ayala
First
Gabriela
DOB
11/20/1970
County
Dekalb
Street
3817 Church St.
City
Clarkston
State
GA
Zip
30021-
Cell
(404) 508-1422
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Some College

Spouse Information

Last
Shamon
First
Marbeen
DOB
02/22/1977
Address
N/A
Telephone
N/A
COB
Irak
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
Mary Shamon Ayala 06/24/2007 Parents GA/USA
Nahreen Shamon Ayala 09/11/2005 Parents GA/USA
NOTES

Media Authoritation

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