CEG-MIR-72

Code
CEG-MIR-72
Mercy ID
V-00086-01
Encounter Date
02/15/2000
Last
Cegueda
First
Miriam
DOB
04/11/1972
County
Gwinnett
Street
4401 lee rd
City
Lithonin
State
GA
Zip
30058-
Home
(770) 922-0127
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Some College

Spouse Information

Last
Martinez
First
Gerardo
DOB
10/30/1969
Address
same
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
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
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
carlos david rosales 08/23/1993 Parents GA/USA
monica guadalupe rosales 03/05/1995 Parents 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
D. Gomez
Referred By