SIL-DAI-83

Code
SIL-DAI-83
Mercy ID
V-02067-01
Encounter Date
11/02/2005
Last
Silve servin
First
Daisy
DOB
05/20/1983
County
Dekalb
Street
6750 Peachtree Industrial Bld.
City
Doraville
State
GA
Zip
30360-
Cell
(678) 499-3410
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Suarez
First
Hugo
DOB
09/05/1978
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
Daisy Suarez 08/04/2005 Parents GA/USA
Linda Marisol Suarez 10/08/2004 Parents Mexico
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