SAL-MIR-63

Code
SAL-MIR-63
Mercy ID
V-00261-01
Encounter Date
08/07/2000
Last
Salazar
First
Mirna
DOB
10/24/1963
County
Dekalb
Street
3500 azlea place
City
Chamblee
State
GA
Zip
30341-
Home
(770) 234-9795
Family Status
Two parent family w/children
COB
Guatemala
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Salazar
First
Felix
Middle
A.
DOB
02/04/1963
Address
N/A
Telephone
N/A
COB
Guatemala
Home Owner
No
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
YES
Consentimiento De Participar
YES

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

Children

NAME DOB LIVING WITH STATE/COUNTRY
cristian salazar 03/07/1994 Parents GA/USA
iris beatriz salazar 04/08/1990 Parents GA/USA
joselyn salazar 03/26/1993 Parents GA/USA
josye salazar 04/01/1996 Parents GA/USA
mirna beatriz salazar 11/28/1987 Parents 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
D. Gomez
Referred By