SAN-PAT-65

Code
SAN-PAT-65
Mercy ID
V-01064-01
Encounter Date
12/24/2002
Last
Sanchez mendoza
First
Patricia
DOB
03/17/1965
County
Clayton
Street
4533 Ryan Rd.
City
Conley
State
GA
Zip
30288-
Home
(404) 363-4899
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Vocational/Technical

Spouse Information

Last
Mendoza
First
Francisco javier
DOB
09/04/1955
Address
N/A
Telephone
N/A
COB
Mexico
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
J. Manzo
Referred By
x7764 Karina