Code
VAR-MAR-86
Mercy ID
V-03354-01
Encounter Date
06/28/2010
Last
Vargas
First
Maria felicitas
DOB
09/16/1986
County
Fulton
Street
21002 Lake Union Hill Way
City
Alpharetta
State
GA
Zip
30004-
Cell
(404) 729-3162
Family Status
Single adult
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
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
DFACS County
Alcohol & Drug
No
# of DUIs
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
Driver License Date
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
Allizon A. Tienda 09/03/2008 Mother GA/USA
Melany M. Tienda 01/26/2007 Mother GA/USA

Former Spouse 1 Information

Last
Tienda
First
Felipe
DOB
02/05/1982
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