CHA-ELS-74

Code
CHA-ELS-74
Mercy ID
V-02692-01
Encounter Date
01/22/2008
Last
Chavero
First
Elsa
DOB
08/22/1974
County
Cobb
Street
1509 Milcord Place
City
Marietta
State
GA
Zip
30008-
Home
(770) 435-6469
Cell
(678) 548-6250
Work
(770) 799-7944
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
H.S. equivalency diploma

Spouse Information

Last
Arboleda
First
Cesar
DOB
N/A
Address
N/A
Telephone
N/A
COB
Perú
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
Jonathan Sanchez 02/10/1998 Mother GA/USA
Sandra Sanchez 10/31/1995 Mother GA/USA

Former Spouse 1 Information

Last
Sanchez
First
Armando
DOB
N/A
Telephone
N/A
COB
Mexico
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
friend