TAV-SHI-55

Code
TAV-SHI-55
Mercy ID
V-00649-01
Encounter Date
08/13/2001
Last
Meraz
First
Shirley
DOB
05/27/1955
County
Dekalb
Street
1119 Penoak Dr.
City
Tucker
State
GA
Zip
30084-
Home
(770) 938-9826
Family Status
Two parent family w/children
COB
Nicaragua
Gender
Female
Housing
Not Homeless
Education Level
High school graduate

Spouse Information

Last
Meral
First
Eduardo
DOB
04/22/1953
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
YES
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
YES

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
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Eduardo Javier Mera 05/24/1999 Parents GA/USA
Heidy Perez Talavera 10/03/1978 Adulto/Soltero Costa Rica
Ronaldo Talavera 12/07/1986 Adulto/Soltero Costa Rica
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
K. Aleman
Referred By
x7764 Michelle