AJT-MAR-90

Code
AJT-MAR-90
Mercy ID
V-03362-01
Encounter Date
07/09/2010
Last
Ajtun
First
Margarita
DOB
07/03/1990
County
Fulton
Street
1940 Fisher Road
City
Atlanta
State
GA
Zip
30315-
Cell
(678) 760-5561
Other
(678) 541-1076
Family Status
Single parent w/children
COB
Guatemala
Gender
Female
Housing
Doubling Up
Education Level
Adult, no formal education

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
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
Anthony Barrera 01/31/2010 Mother GA/USA
Yasmin Barrera 11/22/2006 Mother GA/USA

Former Spouse 1 Information

Last
Barrera
First
Luis
DOB
05/29/1985
Telephone
N/A
COB
Guatemala
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
J. Manzo
Referred By
linea-Juana