SAL-JOS-66

Code
SAL-JOS-66
Mercy ID
V-01761-02
Encounter Date
11/30/2004
Last
Salas
First
Jose hilario
DOB
09/28/1966
County
Cobb
Street
546 Virginia Place
City
Marietta
State
GA
Zip
30067-
Home
(404) 933-6363
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
Preschool

Spouse Information

Last
Espino padilla
First
Maria
DOB
09/07/1972
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
YES
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
Erika N/A Parents GA/USA
Julio N/A N/A GA/USA
Leticia N/A Parents GA/USA
Martha N/A N/A GA/USA
Mary Carmen 07/16/1990 Parents GA/USA
Yasmin N/A N/A GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
R. Miranda
Data Entry
K. Aleman
Referred By
Cobb