CAM-MAR-53

Code
CAM-MAR-53
Mercy ID
V-01307-01
Encounter Date
08/07/2003
Last
Campo
First
Maria
DOB
08/15/1953
County
Gwinnett
Street
535 Camp Perring Road
City
Lawrenceville
State
GA
Zip
30362-
Cell
(678) 760-8302
Family Status
Adult coupie-no children
COB
Colombia
Gender
Female
Housing
Doubling Up
Education Level
College Degree

Spouse Information

Last
Delgado
First
Carlos
DOB
N/A
Address
N/A
Telephone
N/A
COB
Colombia
Home Owner
No
Driver
No
Home Owner
YES
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
YES
Consentimiento De Participar
YES

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
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