AYA-ALM-81

Code
AYA-ALM-81
Mercy ID
V-00231-01
Encounter Date
06/06/2000
Last
Ayala
First
Alma
DOB
03/20/1981
County
Fulton
Street
2424 adina dr apt c
City
Atlanta
State
GA
Zip
30324-
Home
(404) 848-9166
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Marban
First
Jose
DOB
08/04/1976
Address
same
Telephone
(404) 264-1163
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
alondra maria marban 07/25/1999 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
S. Aviña
Referred By