HER-MAR-62

Code
HER-MAR-62
Mercy ID
V-01682-01
Encounter Date
08/16/2004
Last
Hernandez
First
Marina
DOB
01/22/1962
County
Dekalb
Street
not given
City
Not given
State
GA
Zip
00000-0000
Home
(678) 467-3204
Family Status
Single adult
COB
Mexico
Gender
Female
Housing
Transitional
Education Level
some high school

Spouse Information

Last
N/A
First
N/A
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
No
Stranger
YES
As An Adult
YES
Partner
No
Relative
No
Stranger
YES
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
DRCC Ayline/Damaryz