BER-LUZ-64

Code
BER-LUZ-64
Mercy ID
V-02730-01
Encounter Date
03/18/2008
Last
Bernal
First
Luz
DOB
09/25/1964
County
Barrow
Street
1121 Otis Drive
City
Bethlemn
State
GA
Zip
30620-
Cell
(678) 668-5113
Family Status
Two parent family w/children
COB
Colombia
Gender
Female
Housing
Single Family
Education Level
Some College

Spouse Information

Last
Morales
First
Pedro
DOB
02/13/1957
Address
N/A
Telephone
N/A
COB
Colombia
Home Owner
YES
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
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
Luis Felipe Morales 04/08/2005 Parents 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
Jacqueline Cuadra/Banco-amiga