MES-SIL-61

Code
MES-SIL-61
Mercy ID
V-02280-01
Encounter Date
06/26/2006
Last
Mesa
First
Silvia
DOB
07/28/1961
County
Clayton
Street
Tara Blvd #K5
City
Jonesboro
State
GA
Zip
30236-
Cell
(678) 768-0765
Family Status
Single parent w/children
COB
Uruguay
Gender
Female
Housing
Not Homeless
Education Level
Other

Spouse Information

Last
Moreira
First
Alberto
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
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Favian Moreira 04/29/1988 Mother GA/USA
Noelia Moreira 10/30/1997 Mother GA/USA
NOTES

Media Authoritation

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