ARZ-MAR-79

Code
ARZ-MAR-79
Mercy ID
V-02559-01
Encounter Date
08/15/2007
Last
Arzate
First
Maria guadalupe
DOB
01/25/1979
County
Fulton
Street
56 Pld Holcombridge
City
Roswell
State
GA
Zip
30076-
Home
(770) 518-6117
Cell
(404) 775-7969
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
N/A
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
Willy Hidalgo 02/21/2007 Mother GA/USA

Former Spouse 1 Information

Last
Hidalgo
First
Willy
DOB
08/01/2007
Telephone
N/A
COB
Perú
Home Owner
No
NOTES

Media Authoritation

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