CAS-JOS-66

Code
CAS-JOS-66
Mercy ID
V-03397-01
Encounter Date
09/10/2010
Last
Castrejon
First
Josefina
DOB
10/23/1966
County
Dekalb
Street
2744 Achway Dr. # A
City
Chamblee
State
GA
Zip
30341-
Home
(770) 559-3158
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
Flores
First
Sebastian
DOB
N/A
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
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
Emily Flores 01/10/2008 Parents GA/USA
Miriam Flores 03/18/2000 Parents GA/USA
Yeslin Flores 08/29/2001 Parents 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