JUA-MAR-76

Code
JUA-MAR-76
Mercy ID
V-03458-01
Encounter Date
10/25/2010
Last
Juarez
First
Marisol
DOB
04/08/1976
County
Dekalb
Street
2035 Idlewood # H-2
City
Tucker
State
GA
Zip
30084-
Cell
(678) 558-0136
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
High school graduate

Spouse Information

Last
N/A
First
N/A
DOB
N/A
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
No
Consentimiento De Participar
No

Petitioner

TPO
YES
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
Carlos Josue Salgado 02/18/2010 Mother GA/USA
Natalia Salgado 10/15/2001 Mother GA/USA
Valeria Salgado 06/07/2003 Mother GA/USA

Former Spouse 1 Information

Last
Salgado
First
Carlos
DOB
11/05/1976
Telephone
N/A
COB
Mexico
Home Owner
No
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- Griselda