CAR-MAR-63

Code
CAR-MAR-63
Mercy ID
V-02406-02
Encounter Date
01/30/2007
Last
Carrillo
First
Martin
DOB
01/30/1963
County
Dekalb
Street
3096 Buford Hwy Apt. F
City
Atlanta
State
GA
Zip
30329-
Cell
(404) 957-3409
Family Status
Single adult
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Telefores
First
Sofia
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
YES
Dekalb
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
Bryant Carrillo N/A DFACS GA/USA
Luis Antonio Carrillo N/A DFACS GA/USA
Luis Carrillo N/A DFACS GA/USA
Maria de los Angeles Carrillo N/A DFACS GA/USA
Roberto Carrillo N/A DFACS GA/USA
NOTES
DFCS Case Worker Nikke Coleman (404) 370-5047

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
J. Manzo
Referred By
DFCS