Code
SAN-ISA-75
Mercy ID
V-00181-01
Encounter Date
04/19/2000
Last
Sanchez
First
Isabel
DOB
07/08/1975
County
Dekalb
Street
2683 Bronco Tr.
City
Duluth
State
GA
Zip
30096-
Home
(770) 263-9135
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Becerra
First
Jose luis
DOB
03/19/1977
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
DFACS County
Alcohol & Drug
No
# of DUIs
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
Driver License Date
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
Brenda Becerra 10/02/1999 Parents GA/USA
Jose Luis Becerra 03/24/1997 Parents GA/USA
Lucila Becerra 07/29/1993 Parents GA/USA
Maria Becerra 03/30/1992 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
D. Gomez
Referred By