SAL-DAR-99

Code
SAL-DAR-99
Mercy ID
V-03245-11
Encounter Date
01/27/2010
Last
Salazar
First
Darlenne
DOB
03/19/1999
County
Clayton
Street
624 Redfox Trail
City
Jonesboro
State
GA
Zip
30238-
Cell
(404) 453-5767
Family Status
Child/Youth
COB
USA
Gender
Female Child
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
N/A
Home Owner
No
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
YES
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perilla
Data Entry
J. Manzo
Referred By