CAS-BLA-68

Code
CAS-BLA-68
Mercy ID
V-03349-01
Encounter Date
06/22/2010
Last
Casiano
First
Blanca
DOB
11/23/1968
County
Hall
Street
5565 Mulberry St. # A-12
City
Flowery brnach ga
State
GA
Zip
30542-
Cell
(678) 592-0632
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Hernandez
First
Miguel
DOB
06/10/1969
Address
detenido-ICE
Telephone
N/A
COB
Mexico
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
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 Hernandez 05/19/1997 Mother GA/USA
Giselle Hernandez 05/28/2002 Mother GA/USA
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-Juana