HIP-ELE-46

Code
HIP-ELE-46
Mercy ID
V-02677-01
Encounter Date
12/13/2007
Last
Hipolito
First
Elena
DOB
10/26/1946
County
Newton
Street
2277 Christian Cir. S.E.
City
Conyers
State
GA
Zip
30013-
Cell
(404) 723-6075
Family Status
Single adult
COB
Cuba
Gender
Female
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Hipolito
First
Miguel
DOB
03/06/1946
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
YES
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
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