FIG-ISA-57

Code
FIG-ISA-57
Mercy ID
V-00757-01
Encounter Date
12/05/2001
Last
Figueroa
First
Isabel
DOB
07/08/1957
County
Dekalb
Street
5315 Kemper Place
City
Stone mountain
State
GA
Zip
30088-
Home
(770) 498-0934
Family Status
Single parent w/children
COB
Puerto Rico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Figueroa
First
Mario
DOB
05/19/1953
Address
N/A
Telephone
(770) 416-9165
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
YES
Consentimiento De Participar
YES

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
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