CUA-CLA-65

Code
CUA-CLA-65
Mercy ID
V-01293-01
Encounter Date
07/23/2003
Last
Cuaspud
First
Clara
DOB
06/21/1965
County
Gwinnett
Street
3244 W. Summit Point Apt. C
City
Norcross
State
GA
Zip
30092-
Home
(770) 242-0364
Family Status
Single parent w/children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
High school graduate

Spouse Information

Last
Zambrano
First
John
Middle
J.
DOB
03/10/1972
Address
N/A
Telephone
N/A
COB
Colombia
Home Owner
No
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
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
YES
Relative
YES
Stranger
No
As An Adult
YES
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Diana Carolina Zambrano 11/09/1990 Father GA/USA
Jairo Andres Zambrano 04/12/2000 Father GA/USA
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