VIN-FAV-74

Code
VIN-FAV-74
Mercy ID
V-02738-01
Encounter Date
03/13/2008
Last
Vina
First
Faviola
DOB
02/20/1974
County
Other
Street
516 Chetsstra Cr.
City
Chelsea
State
AL
Zip
35043-
Cell
(678) 267-0236
Family Status
Adult couple-no children
COB
Venezuela
Gender
Female
Housing
Single Family
Education Level
High school graduate

Spouse Information

Last
Zarape
First
Alvaro
DOB
12/07/1983
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
SOLO
No
Court Mandated
YES
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
YES
Stay Away Condition
YES
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
Jose Aangel Boada 09/29/2001 Father GA/USA
Luis Jose Boada 10/25/1995 Father GA/USA

Former Spouse 1 Information

Last
Guada
First
Jose luis
DOB
09/30/1968
Telephone
N/A
COB
Venezuela
Home Owner
YES
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
linea-Griselda