SER-SAN-80

Code
SER-SAN-80
Mercy ID
V-02267-01
Encounter Date
06/09/2006
Last
Serrano
First
Sandra
DOB
03/10/1980
County
Dekalb
Street
5023 Buford Hwy
City
Doraville
State
GA
Zip
30340-
Family Status
Single adult
COB
Guatemala
Gender
Female
Housing
Doubling Up
Education Level
Adult, no formal education

Spouse Information

Last
Mendez
First
Leonardo
DOB
10/12/1970
Address
N/A
Telephone
N/A
COB
El Salvador
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
YES
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
G. Landeros
Data Entry
R. Gonzalez
Referred By