THI-ROX-66

Code
THI-ROX-66
Mercy ID
V-00467-01
Encounter Date
04/09/2001
Last
Thiers
First
Roxana
DOB
11/25/1966
County
Gwinnett
Street
homeless
City
Norcross
State
GA
Zip
00000-
Home
(770) 923-1926
Family Status
Adult coupie-no children
COB
Chile
Gender
Female
Housing
Street
Education Level
Vocational/Technical

Spouse Information

Last
Thiers
First
Elias
DOB
12/10/1960
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
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
matias ignacio 12/17/1991 Grandfather GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
S. Aviña
Referred By
7764 rebbeca