DIA-MAR-60

Code
DIA-MAR-60
Mercy ID
V-02248-01
Encounter Date
05/18/2006
Last
Diaz
First
Maria janet
DOB
06/10/1960
County
Fulton
Street
not given
City
Not given
State
GA
Zip
00000-
Home
(404) 713-1227
Family Status
Single adult
COB
Guatemala
Gender
Female
Housing
Street
Education Level
some high school

Spouse Information

Last
Bamaca
First
Jose luis
DOB
N/A
Address
N/A
Telephone
N/A
COB
Guatemala
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
Alvaro L Bamaco N/A Adulto/Soltero Guatemala
Sergia A Bamaco N/A Adulto/Soltero Guatemala
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
R. Gonzalez
Referred By
walk in