FLO-SEL-80

Code
FLO-SEL-80
Mercy ID
V-02014-02
Encounter Date
09/13/2005
Last
Flores
First
Selving
DOB
01/31/1980
County
Dekalb
Street
2953 N. Dekalb
City
Doraville
State
GA
Zip
30340-
Home
(678) 458-1909
Family Status
Two parent family w/children
COB
El Salvador
Gender
Male
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Castillo
First
Blanca estela
DOB
08/14/1972
Address
N/A
Telephone
(678) 458-1909
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
No
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
Casandra Salazar N/A Parents GA/USA
Fernando Salazar N/A Parents GA/USA
Isrrael Flores N/A Parents GA/USA
Luis Salazar N/A Parents GA/USA
Maria Elena Salazar N/A Parents GA/USA
Marta Flores N/A Parents GA/USA
Vianca Flores N/A Parents GA/USA
NOTES

Media Authoritation

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