CAM-PAM-83

Code
CAM-PAM-83
Mercy ID
V-01111-01
Encounter Date
02/10/2003
Last
Campino
First
Pamela
DOB
12/20/1983
County
Gwinnett
Street
112 Dannager Way
City
Lawrenceville
State
GA
Zip
30045-
Home
(678) 663-1591
Family Status
Two parent family w/children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
High school graduate

Spouse Information

Last
Anpakikan
First
Tony
DOB
N/A
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
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Joshua Anpakikan 06/11/2003 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
R. Gonzalez
Referred By
Karina Miller 7764