HER-DAM-72

Code
HER-DAM-72
Mercy ID
V-01131-01
Encounter Date
02/21/2003
Last
Hernandez
First
Damariz
DOB
06/30/1972
County
Dekalb
Street
3655 Chestnut Dr. Apt A-1
City
Doraville
State
GA
Zip
30340-
Home
(770) 457-4714
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Garcia
First
Adam
DOB
12/21/1963
Address
2941 Northdekalb Dr. Apt. 107
Telephone
N/A
COB
EEUU
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
Amber Garcia 10/21/1998 Parents GA/USA
Israel Sixto 09/03/1991 Parents GA/USA
John Garcia 10/13/2000 Parents 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
x3737 Damariz