DEN-SAR-61

Code
DEN-SAR-61
Mercy ID
V-00705-01
Encounter Date
09/28/2001
Last
Denham
First
Sara
DOB
07/22/1961
County
Other
Street
2390 Fairburn Rd. Lot 158
City
Douglassville
State
GA
Zip
30135-
Home
(770) 577-4127
Family Status
Adult coupie-no children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
College Degree

Spouse Information

Last
Denham
First
Mike
DOB
04/04/1952
Address
N/A
Telephone
N/A
COB
EEUU
Home Owner
YES
Driver
No
Home Owner
YES
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
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
K. Aleman
Referred By
xx7764 Michelle