SAL-PAT-67

Code
SAL-PAT-67
Mercy ID
V-00786-01
Encounter Date
12/31/2001
Last
Salazar
First
Patricia
DOB
09/25/1967
County
Gwinnett
Street
961 Karla Place
City
Norcross
State
GA
Zip
30093-
Home
(678) 508-7778
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Zuñiga
First
Eulogio
DOB
08/14/1961
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
YES
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
Benjamin Zuñiga 12/30/1999 Parents GA/USA
Jose Luis Zuñiga 10/14/1993 Parents GA/USA
Sandra Elizabeth Zuñiga 11/11/1996 Parents GA/USA
Sara Yesica Zuñiga 11/26/1995 Parents GA/USA
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