VAL-SAR-59

Code
VAL-SAR-59
Mercy ID
V-00832-01
Encounter Date
01/28/2002
Last
Valdez
First
Sara
DOB
04/13/1959
County
Dekalb
Street
3598 E Meadlow Glenn
City
Doraville
State
GA
Zip
30340-
Home
(678) 485-8251
Cell
(770) 409-3233
Family Status
Adult coupie-no children
COB
Chile
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Farias
First
Fernando
DOB
12/30/1949
Address
N/A
Telephone
N/A
COB
Chile
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
YES
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
x7764 Rebecca