CAS-SAI-83

Code
CAS-SAI-83
Mercy ID
V-03186-01
Encounter Date
10/15/2009
Last
Castillo
First
Saira
DOB
07/13/1983
County
Dekalb
Street
931 Woodterrace Court
City
Doraville
State
GA
Zip
30341-
Cell
(404) 578-7513
Family Status
Single parent w/children
COB
Honduras
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
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
YES
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
Cristy Brown 12/20/2001 Mother GA/USA
Maverick Brown 05/12/2003 Mother GA/USA

Former Spouse 1 Information

Last
Brown
First
Gerardo
DOB
04/14/1974
Telephone
N/A
COB
Honduras
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
linea-Juana