SAL-MAR-04

Code
SAL-MAR-04
Mercy ID
V-01766-01
Encounter Date
11/23/2004
Last
Saldaña
First
Maria
DOB
04/29/1974
County
Dekalb
Street
4282 English Oak Dr. Apt J-3
City
Doraville
State
GA
Zip
30340-
Cell
(770) 256-1152
Family Status
Single parent w/children
COB
Ecuador
Gender
Female
Housing
Doubling Up
Education Level
Adult, no formal education

Spouse Information

Last
Lazo
First
Carlos
DOB
N/A
Address
N/A
Telephone
N/A
COB
Ecuador
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
Cristian Mauricio Lazo N/A Grandmother Ecuador
John Henry Lazo 10/07/1994 Mother GA/USA
Jorge Luis Lazo 06/10/1990 Grandmother Ecuador
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
Walk-in/Mision