BON-FAN-79

Code
BON-FAN-79
Mercy ID
V-01076-01
Encounter Date
01/09/2003
Last
Bonilla
First
Fany
DOB
04/19/1979
County
Dekalb
Street
3658 Buford Hwy Apt. C-25
City
Atlanta
State
GA
Zip
30329-
Home
(404) 325-8350
Family Status
Single parent w/children
COB
Honduras
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Pacheco
First
Jorge
Middle
R.
DOB
02/04/1979
Address
N/A
Telephone
N/A
COB
Honduras
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
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
Jackson Pacheco 09/19/2002 N/A 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
x3737 Damariz