VAR-YAM-86

Code
VAR-YAM-86
Mercy ID
V-03335-01
Encounter Date
05/26/2010
Last
Smith
First
Yamileth
DOB
10/15/1986
County
Cobb
Street
861 Franklin Rd.
City
Marietta
State
GA
Zip
30067-
Cell
(404) 645-4411
Family Status
Two parent family w/children
COB
Honduras
Gender
Female
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Perez
First
Eduardo
DOB
09/26/1985
Address
N/A
Telephone
N/A
COB
Mexico
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

Children

NAME DOB LIVING WITH STATE/COUNTRY
Jowell Smith 02/02/2010 Parents GA/USA
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