BAL-LUZ-64

Code
BAL-LUZ-64
Mercy ID
V-01232-01
Encounter Date
05/20/2003
Last
Balsa
First
Luz marina
DOB
05/09/1964
County
Dekalb
Street
706 Jolly Ave. Sur Apt 5
City
Clarkston
State
GA
Zip
30021-
Home
(404) 298-8963
Family Status
Adult coupie-no children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
College Degree

Spouse Information

Last
Al hileje
First
Abid
DOB
01/01/1969
Address
N/A
Telephone
N/A
COB
Other
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. Perez
Data Entry
K. Aleman
Referred By
x3737 Damaryz