MUR-SAN-76

Code
MUR-SAN-76
Mercy ID
V-01471-01
Encounter Date
01/26/2004
Last
Murillo
First
Sandra
DOB
07/25/1976
County
Gwinnett
Street
5307 Greenleaf Dr.
City
Lilburn
State
GA
Zip
30047-
Home
(770) 557-0842
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Salazar
First
Luis
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
YES
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
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
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Jesus Guadalupe Salazar 10/01/2004 Parents GA/USA
Luis Salazar 03/07/1997 Parents GA/USA
Maria Salazar 02/24/1996 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