CLE-MIZ-84

Code
CLE-MIZ-84
Mercy ID
V-02492-01
Encounter Date
05/10/2007
Last
Cleghorne
First
Mizcell
DOB
11/21/1984
County
Clark
Street
105 Chateau Court Apt. 11
City
Athens
State
GA
Zip
30606-
Cell
(706) 248-8146
Family Status
Single parent w/children
COB
Perú
Gender
Female
Housing
Single Family
Education Level
Vocational/Technical

Spouse Information

Last
Cleghorne
First
Michael
DOB
12/11/1980
Address
N/A
Telephone
N/A
COB
USA
Home Owner
YES
Driver
No
Home Owner
YES
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
Jazmin Ariela Cleghorne 02/06/2002 Mother 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
J. Manzo
Referred By
Amiga