BRA-MAR-84

Code
BRA-MAR-84
Mercy ID
V-03497-01
Encounter Date
01/05/2011
Last
Bravo
First
Maria
DOB
11/19/1984
County
Fulton
Street
141 Old Holcombridge Way
City
Roswell
State
GA
Zip
30076-
Cell
(678) 891-8474
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Del carmen
First
Felipe
DOB
10/16/1979
Address
N/A
Telephone
(678) 900-4835
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
YES
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
Jesse Bravo 03/17/2008 Mother GA/USA
NOTES

Media Authoritation

DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
C. Martinez
Data Entry
J. Manzo
Referred By
walk in