AVI-SAI-75

Code
AVI-SAI-75
Mercy ID
B-00029-01
Encounter Date
01/26/1998
Last
Avila
First
Saida
DOB
11/21/1975
County
Dekalb
Street
5082 Benttreloop
City
Stone mountain
State
GA
Zip
30083-
Home
(770) 498-8362
Family Status
Adult coupie-no children
COB
Honduras
Gender
Female
Housing
Not Homeless
Education Level
H.S. equivalency diploma

Spouse Information

Last
Elijio
First
Jose antonio
DOB
N/A
Address
N/A
Telephone
N/A
COB
Honduras
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
Anneyeth Eligio Avila N/A N/A 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
K. Aleman
Referred By