SIL-CES-81

Code
SIL-CES-81
Mercy ID
V-01919-02
Encounter Date
06/27/2005
Last
Franco
First
Carlos
DOB
05/22/1981
County
Cobb
Street
1250 Pinehurts Cir.
City
Smyrna
State
GA
Zip
30080-
Cell
(404) 944-4216
Family Status
Two parent family w/children
COB
Perú
Gender
Male
Housing
Single Family
Education Level
High school graduate

Spouse Information

Last
Harris
First
Sally
DOB
12/29/1980
Address
N/A
Telephone
(404) 644-8470
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
YES
DFCS Mandated
No
Alcohol & Drug
No
Partner Referred to Tepestri
No
Recidivism/Court
No
New Incident
No
Promesa de Confidencialidad
YES
Consentimiento De Participar
No

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

TPO
No
Stay Away Condition
No
Mutual
No
Driver
No
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
Sheldon Harris 03/03/2000 Grandmother ALA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
R. Miranda
Data Entry
K. Aleman
Referred By