VAZ-MAR-89

Code
VAZ-MAR-89
Mercy ID
V-03385-01
Encounter Date
08/09/2010
Last
Vazquez
First
Maria guadalupe
DOB
09/16/1989
County
Cobb
Street
1019 Flankling Road
City
Marietta
State
GA
Zip
30067-
Cell
(678) 914-3365
Other
(678) 789-0230
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
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
Aleen Pineda 06/30/2009 Mother GA/USA
Christian Pineda 11/16/2007 Mother GA/USA

Former Spouse 1 Information

Last
Pineda
First
Christian
DOB
12/10/1988
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-Juana