RAM-BEN-53

Code
RAM-BEN-53
Mercy ID
V-00163-01
Encounter Date
04/05/2000
Last
Ramirez
First
Benigna
DOB
02/14/1953
County
Cobb
Street
768 Roger Way
City
Marietta
State
GA
Zip
30064-
Home
(770) 541-6489
Family Status
Adult coupie-no children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Peña
First
Guadalupe
DOB
08/05/1939
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
Maria Lugo Peña 04/17/1988 N/A GA/USA
Norailda De Aguila 02/01/1969 N/A 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
D. Gomez
Referred By