CAR-JAN-60

Code
CAR-JAN-60
Mercy ID
V-03455-01
Encounter Date
10/29/2010
Last
Cardin
First
Janeth
DOB
11/22/1960
County
Gwinnett
Street
3028 Merrion Park
City
Dacula
State
GA
Zip
30019-
Cell
(770) 375-0841
Family Status
Two parent family w/children
COB
Colombia
Gender
Female
Housing
Single Family
Education Level
Some College

Spouse Information

Last
Cardin
First
John
DOB
N/A
Address
N/A
Telephone
N/A
COB
USA
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
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
Michell Cardin 12/19/1989 Mother GA/USA
Nicole Cardin 05/16/1993 Mother GA/USA
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-Griselda