MAN-JUL-77

Code
MAN-JUL-77
Mercy ID
V-03316-01
Encounter Date
05/03/2010
Last
Mancia
First
Julimar
DOB
10/01/1977
County
Cowetta
Street
165 Barrington Branche Dr.
City
Fharepurg
State
GA
Zip
30277-
Cell
(770) 283-7526
Family Status
Single adult
COB
Puerto Rico
Gender
Female
Housing
Single Family
Education Level
College Degree

Spouse Information

Last
Mancia
First
Oscar
DOB
09/18/1972
Address
N/A
Telephone
N/A
COB
El Salvador
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
YES
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

Former Spouse 1 Information

Last
Mancia
First
Oscar
DOB
09/18/1972
Telephone
N/A
COB
Ela Salvador
Home Owner
YES
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
YES
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By
linea-Juana