BIB-LUZ-89

Code
BIB-LUZ-89
Mercy ID
V-02561-01
Encounter Date
08/20/2007
Last
Bibiano
First
Luz
DOB
06/11/1989
County
Dekalb
Street
4339 Hickory Wood
City
Doraville
State
GA
Zip
30360-
Home
(678) 620-2166
Cell
(678) 927-1641
Other
(678) 927-1641
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Palma
First
Israel
DOB
10/26/1984
Address
N/A
Telephone
N/A
COB
Mexico
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
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
Brian Palma 05/11/2006 Parents 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
Felipe