BAR-EVE-78

Code
BAR-EVE-78
Mercy ID
V-03076-01
Encounter Date
05/18/2009
Last
Barrios
First
Evelyn
DOB
04/08/1978
County
Cobb
Street
400 Alexander Dr. Apt. 201
City
Canton
State
GA
Zip
30114-
Cell
(678) 315-9373
Other
(678) 499-9034
Family Status
Single parent w/children
COB
El Salvador
Gender
Female
Housing
Doubling Up
Education Level
Some College

Spouse Information

Last
Brown
First
Ernest
DOB
07/03/1964
Address
N/A
Telephone
N/A
COB
USA
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
Fernando I. Brown 09/17/2007 Mother GA/USA
Karla Barrios 09/10/2002 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