BAI-ANA-78

Code
BAI-ANA-78
Mercy ID
V-02986-01
Encounter Date
01/16/2009
Last
Baird
First
Ana
DOB
02/09/1978
County
Fulton
Street
3181 Lynwood Dr.
City
Atlanta
State
GA
Zip
30319-
Cell
(404) 438-5208
Family Status
Single adult
COB
Colombia
Gender
Female
Housing
Single Family
Education Level
College Degree

Spouse Information

Last
Barclai
First
Lonnie
DOB
06/07/1962
Address
Gimnacio
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
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
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
Cristina