WHI-COL-64

Code
WHI-COL-64
Mercy ID
V-00083-01
Encounter Date
08/25/1999
Last
Whitman
First
Collen
DOB
03/18/1964
County
Dekalb
Street
3236 mathirson dr ne
City
Atlanta
State
GA
Zip
30305-
Home
(404) 812-0077
Family Status
Two parent family w/children
COB
Other
Gender
Female
Housing
Other
Education Level
Some College

Spouse Information

Last
Vega
First
Constantino
DOB
05/10/1966
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
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
S. Aviña
Referred By