JAI-ZHE-73

Code
JAI-ZHE-73
Mercy ID
V-02615-01
Encounter Date
10/10/2007
Last
Jaime
First
Zhenia
DOB
09/30/1973
County
Other
Street
406 W. Lincoln Dr.
City
Harlingen
State
TX
Zip
78550-
Home
(956) 281-3491
Cell
(956) 577-3859
Other
(956) 970-3856
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
College Degree

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
N/A
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
YES
Consentimiento De Participar
YES

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
Edson Segura 08/10/2006 Mother TX/USA
Janeth Segura 08/21/2004 Mother TX/USA

Former Spouse 1 Information

Last
Segura
First
Jose
DOB
03/16/1972
Telephone
N/A
COB
N/A
Home Owner
YES
NOTES
Referida a PADV. shelter (770) 413-5557. Dr. Cony (404) 523-6571 ext. 223

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By
walkin