MAR-ELD-71

Code
MAR-ELD-71
Mercy ID
V-01039-01
Encounter Date
11/26/2002
Last
Marin
First
Elda
DOB
05/14/1971
County
Dekalb
Street
3425 Cumberland Dr.
City
Chamblee
State
GA
Zip
30341-
Home
(770) 454-7443
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Vocational/Technical

Spouse Information

Last
De leon
First
Elda
DOB
05/14/1971
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
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
Fabiola De leon 10/15/2000 Mother GA/USA
Junior De leon 08/13/1999 Mother GA/USA
Karen Marin 09/30/1990 Mother GA/USA
Michell Marin 09/27/1997 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
x7764 Karina Miller