MEN-HAY-85

Code
MEN-HAY-85
Mercy ID
V-03255-01
Encounter Date
02/09/2010
Last
Mendivil
First
Haylin
DOB
12/03/1985
County
Newton
Street
360 Lakeside Point
City
Covington
State
GA
Zip
30016-
Cell
(770) 728-3589
Family Status
Adult couple-no children
COB
Colombia
Gender
Female
Housing
Doubling Up
Education Level
Vocational/Technical

Spouse Information

Last
Johnson
First
David
DOB
12/16/1969
Address
Africanamerican
Telephone
N/A
COB
USA
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
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
Linea-Juana