SAL-MAR-73

Code
SAL-MAR-73
Mercy ID
V-02062-01
Encounter Date
10/21/2005
Last
Salazar
First
Maria jose
DOB
04/26/1973
County
Dekalb
Street
6800 Peachtree Industrial Blvd.
City
Doraville
State
GA
Zip
30360-
Cell
(770) 256-6845
Family Status
Two parent family w/children
COB
Guatemala
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Ramirez
First
Jose roberto
DOB
N/A
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
No
Consentimiento De Participar
No

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
Gardenia Carteño 06/12/1993 Parents GA/USA
Jose Roberto Ramirez 08/20/2002 Parents GA/USA
Katerin Victuria Salazar 10/03/2000 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
R. Gonzalez
Referred By