CAM-CLA-73

Code
CAM-CLA-73
Mercy ID
V-00334-01
Encounter Date
11/07/2000
Last
Campos
First
Claudia
DOB
09/25/1973
County
Cobb
Street
114 hillcrest chase terrace
City
Austell
State
GA
Zip
30168-
Home
(770) 944-3122
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Campos
First
Juan de dios
DOB
09/30/1971
Address
58 timoty ln lilburn ga 30247
Telephone
(770) 925-0377
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
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
stacy campos 11/08/1996 Mother 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
D. Gomez
Referred By
maria puche legal aid