LAR-MAR-79

Code
LAR-MAR-79
Mercy ID
V-02542-01
Encounter Date
07/06/2007
Last
Lara
First
Maria del carmen
DOB
02/24/1979
County
Gwinnett
Street
965 Cristal Water Dr.
City
Lawrenceville
State
GA
Zip
30045-
Home
(770) 466-6166
Cell
(631) 991-8667
Family Status
Single parent w/children
COB
El Salvador
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Chavarria
First
Efrain
DOB
06/01/1976
Address
N/A
Telephone
N/A
COB
El Salvador
Home Owner
YES
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
Jaqelin Melissa Lara Chavarria 08/10/2004 Mother GA/USA
Stephany Lizet Lara Chavarria 05/19/1997 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
linea