CAS-SUS-57

Code
CAS-SUS-57
Mercy ID
V-01641-01
Encounter Date
06/30/2004
Last
Castillo
First
Susana
DOB
11/12/1957
County
Dekalb
Street
3600 Shallowford Apt B-7
City
Chamblee
State
GA
Zip
30341-
Home
(770) 216-8467
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up

Spouse Information

Last
Ramos
First
Adalid
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
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
YES
Relative
YES
Stranger
No
As An Adult
YES
Partner
No
Relative
No
Stranger
YES

Children

NAME DOB LIVING WITH STATE/COUNTRY
Saira Susana Calix Castillo N/A N/A 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
Luis/Mision Catolica