BAR-EVA-65

Code
BAR-EVA-65
Mercy ID
V-00752-01
Encounter Date
11/13/2001
Last
Barajas
First
Eva
DOB
06/20/1965
County
Dekalb
Street
2232 Plaster Rd. Apt. A
City
Chamblee
State
GA
Zip
00000-0000
Home
(404) 325-5920
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Aguilar
First
Isidoro
DOB
02/09/1961
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
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
Francisco Aguilar 08/15/1983 Sister Mexico
Graciela Aguilar 10/28/1982 Mother GA/USA
Gustavo Aguilar 07/07/1994 Sister Mexico
Juan Isidro Aguilar 02/09/1986 Mother 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
K. Aleman
Referred By
Evaluacion/Rafa