ATR-ARA-71

Code
ATR-ARA-71
Mercy ID
V-01522-01
Encounter Date
03/09/2004
Last
Atrisco
First
Araceli
DOB
03/21/1971
County
Gwinnett
Street
861 Simontons Preserve Rd.
City
Lawrenceville
State
GA
Zip
00000-000
Home
(770) 995-5209
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Vocational/Technical

Spouse Information

Last
Martinez
First
Carlos
DOB
02/17/1971
Address
N/A
Telephone
(770) 554-9033
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
Carlos Martinez 08/15/2000 Mother GA/USA
Karla Martinez 04/06/1992 Mother GA/USA
Sandra Patricia Martinez 08/29/1994 Mother 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
x1375 Damaryz