AGU-MIR-75

Code
AGU-MIR-75
Mercy ID
V-03037-01
Encounter Date
03/30/2009
Last
Aguilar
First
Mireya
DOB
07/03/1975
County
Dekalb
Street
3460 Buford Hwy # F-1
City
Atlanta
State
GA
Zip
30329-
Cell
(404) 552-8936
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
YES
Alcohol & Drug
No
Partner Referred to Tepestri
No
Recidivism/Court
No
New Incident
No
Promesa de Confidencialidad
YES
Consentimiento De Participar
YES

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
Angel Quiroz 03/16/2008 Mother GA/USA
Erick I. Aguilar 10/16/1997 Mother GA/USA
Rosa Quiros 01/18/2006 Mother GA/USA

Former Spouse 1 Information

Last
Quiroz
First
Joaquín
DOB
05/21/1980
Telephone
N/A
COB
Mexico
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
linea-Griselda