CIF-NAN-80

Code
CIF-NAN-80
Mercy ID
V-03166-01
Encounter Date
09/16/2009
Last
Cifuentes
First
Nancy
DOB
01/12/1980
County
Dekalb
Street
2955 North Dekalb Dr. #301
City
Chamblee
State
GA
Zip
30340-
Cell
(770) 256-2574
Family Status
Two parent family w/children
COB
Guatemala
Gender
Female
Housing
Single Family
Education Level
College Degree

Spouse Information

Last
Calderon
First
Yesrin
DOB
02/22/1984
Address
N/A
Telephone
N/A
COB
Guatemala
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
Nancy cifuentes 11/19/2004 Mother w/Stepfather GA/USA
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