PAL-SIL-78

Code
PAL-SIL-78
Mercy ID
V-02065-01
Encounter Date
10/31/2005
Last
Palma
First
Silvia patricia
DOB
08/16/1978
County
Gwinnett
Street
1137 Northwood Lake
City
Duluth
State
GA
Zip
30096-
Cell
(770) 330-6130
Family Status
Two parent family w/children
COB
Ecuador
Gender
Female
Housing
Not Homeless
Education Level
High school graduate

Spouse Information

Last
Palma
First
David
DOB
08/16/1976
Address
N/A
Telephone
N/A
COB
Guatemala
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
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
Jose David Palma 02/08/2004 Parents 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
R. Gonzalez
Referred By