DIA-YUR-84

Code
DIA-YUR-84
Mercy ID
V-02964-01
Encounter Date
12/10/2008
Last
Diaz
First
Yuridia
DOB
09/21/1984
County
Gwinnett
Street
4885 Indian Trail Rd.
City
Lilburn
State
GA
Zip
30047-
Cell
(770) 923-9526
Other
(770) 923-2695
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
Colon
First
Henry
DOB
06/05/1964
Address
Policia
Telephone
N/A
COB
USA
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
YES
Consentimiento De Participar
YES

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
Ashley Cabello 01/23/2005 Parents GA/USA
Brittany Cabello 05/21/2003 Father GA/USA
Yajaira Pazol 09/29/2006 Mother w/Stepfather GA/USA

Former Spouse 1 Information

Last
Cabello
First
Jose luis
DOB
N/A
Telephone
N/A
COB
N/A
Home Owner
No

Former Spouse 2 Information

Last
L?????????????????????????????
First
L?????????????????????????????
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
J. Perez
Data Entry
J. Manzo
Referred By
walk in