Code
DUR-WIL-66
Mercy ID
V-01347-02
Encounter Date
06/28/1999
Last
Duran
First
William
DOB
09/04/1966
County
Dekalb
Street
4658 Hairston Crossing Way
City
Stone mountain
State
GA
Zip
30083-
Home
(404) 297-8803
Family Status
Two parent family w/children
COB
Venezuela
Gender
Male
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Afanador
First
Lidia
DOB
09/04/1966
Address
N/A
Telephone
N/A
COB
Venezuela
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
DFACS County
Alcohol & Drug
No
# of DUIs
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
Driver License Date
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
Coisel Duran 01/01/2000 Parents GA/USA
Wendy Duran 07/11/1990 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
F. Perez
Data Entry
K. Aleman
Referred By
Judith McCooveal