LUN-LIZ-81

Code
LUN-LIZ-81
Mercy ID
V-03382-01
Encounter Date
08/03/2010
Last
Luna
First
Lizett
DOB
03/01/1981
County
Dekalb
Street
7062 Rogers Lake Road
City
Litonia
State
GA
Zip
30058-
Cell
(404) 951-4152
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
College Degree

Spouse Information

Last
Zimbron
First
Gerardo
DOB
11/02/1978
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
YES
Consentimiento De Participar
YES

Petitioner

TPO
No
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
Yarzari Lizett Zimbrom 12/17/2006 Mother GA/USA
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