DIA-CLA-60

Code
DIA-CLA-60
Mercy ID
V-00235-01
Encounter Date
06/05/2000
Last
Diaz
First
Clara
DOB
04/02/1960
County
Fulton
Street
1304 summer way
City
Dunwoody
State
GA
Zip
30350-
Home
(770) 518-6719
Family Status
Single parent w/children
COB
Colombia
Gender
Female
Housing
Doubling Up
Education Level
College Degree

Spouse Information

Last
Cascante
First
Rafael
DOB
05/29/1958
Address
N/A
Telephone
N/A
COB
Colombia
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
YES
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
S. Aviña
Referred By
legal aid