ESC-BLA-81

Code
ESC-BLA-81
Mercy ID
V-02674-01
Encounter Date
12/24/2007
Last
Escoto
First
Blanca
DOB
09/08/1981
County
Dekalb
Street
2214 Master Road #-B
City
Chamblee
State
GA
Zip
30345-
Cell
(678) 913-8751
Family Status
Single parent w/children
COB
Honduras
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Donaide
First
Angel
DOB
09/08/1978
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
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
Bianca Donaide 01/02/2008 Parents GA/USA

Former Spouse 1 Information

Last
Donaire
First
Angel
DOB
09/08/1978
Telephone
N/A
COB
Honduras
Home Owner
No
NOTES

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
linea-Juana