SIL-BLA-73

Code
SIL-BLA-73
Mercy ID
V-01681-01
Encounter Date
08/19/2004
Last
Silva
First
Blanca
DOB
01/05/1973
County
Gwinnett
Street
5147 Aberdeen Ct. NW
City
Lilburn
State
GA
Zip
30047-
Home
(770) 717-1353
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Colica
First
Oscar
DOB
08/06/1972
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
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Dennise Alejandra Colica 09/15/1996 Parents GA/USA
Due Date 12/06/2004 Mother GA/USA
Oscar Steven Colica 09/08/2002 Parents GA/USA
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
xWalk in Mision