GAL-JUA-58

Code
GAL-JUA-58
Mercy ID
V-00530-02
Encounter Date
05/22/2001
Last
Galvan
First
Juan
DOB
05/30/1958
County
Fulton
Street
1291 clermont ave
City
Eastpoint
State
GA
Zip
30344-
Home
(404) 766-5272
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Mc pherson
First
Janett
DOB
03/02/1975
Address
same
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
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
erica nikol galvan 11/13/1996 Parents GA/USA
juan mosqueda 10/05/1995 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
R. Miranda
Data Entry
D. Gomez
Referred By
sylvial smith fulton