EUN-LID-73

Code
EUN-LID-73
Mercy ID
V-02663-01
Encounter Date
12/03/2007
Last
Funes
First
Lidice
DOB
08/01/1973
County
Cobb
Street
2916 Masonwood
City
Kennesaw
State
GA
Zip
30152-
Cell
(678) 522-0776
Family Status
Two parent family w/children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
Some College

Spouse Information

Last
Funes
First
Carlos
DOB
06/10/1966
Address
N/A
Telephone
N/A
COB
El Salvador
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

Children

NAME DOB LIVING WITH STATE/COUNTRY
Kevin Funes 07/13/2005 Parents GA/USA
Nujad Bolivar 07/21/1992 Mother GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
J. Manzo
Referred By
paginas amarillas