SAL-MER-49

Code
SAL-MER-49
Mercy ID
V-00638-01
Encounter Date
07/30/2001
Last
Salcedo
First
Mercedes
DOB
07/22/1949
County
Gwinnett
Street
2820 Blue Bird Circle
City
Duluth
State
GA
Zip
30096-
Home
(678) 475-1203
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Vocational/Technical

Spouse Information

Last
Ferguson
First
Lee
DOB
07/19/1950
Address
N/A
Telephone
N/A
COB
Mexico
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
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
Maribel Vivanco N/A Adulto/Casado Ecuador
Santiago Vivanco 08/04/1990 Mother w/Stepfather GA/USA
Silvana Vivanco N/A Adulto/Casado Atlanta
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
K. Aleman
Referred By
x7764 Michelle