WES-SHU-72

Code
WES-SHU-72
Mercy ID
V-02358-01
Encounter Date
10/31/2006
Last
West
First
Shura
DOB
05/03/1972
County
Gwinnett
Street
5138 Sugar Lane
City
Norcross
State
GA
Zip
30098-
Cell
(678) 330-1670
Family Status
Single parent w/children
COB
USA
Gender
Female
Housing
Not Homeless
Education Level
High school graduate

Spouse Information

Last
Peru
First
Silva
DOB
N/A
Address
N/A
Telephone
N/A
COB
Perú
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
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
J. Manzo
Referred By
Felipe