ZAN-LUC-65

Code
ZAN-LUC-65
Mercy ID
V-03138-01
Encounter Date
08/17/2009
Last
Zanelli
First
Lucia
DOB
10/21/1965
County
Cobb
Street
4575 River # 4
City
Atlanta
State
GA
Zip
30339-
Cell
(404) 808-2382
Family Status
Single adult
COB
Perú
Gender
Female
Housing
Single Family
Education Level
Some College

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
N/A
Home Owner
No
Driver
No
Home Owner
No
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
YES
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
Adultos N/A N/A GA/USA

Former Spouse 1 Information

Last
Boemker
First
David
DOB
08/06/1955
Telephone
N/A
COB
USA
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 de informacion