GAR-HIL-75

Code
GAR-HIL-75
Mercy ID
V-00558-01
Encounter Date
05/25/2001
Last
Garcia
First
Hilda
DOB
09/20/1975
County
Dekalb
Street
2749 Shallowford Rd. #D
City
Chamblee
State
GA
Zip
30004-1
Home
(770) 986-4250
Family Status
Single parent w/children
COB
Guatemala
Gender
Female
Housing
Doubling Up
Education Level
Adult, no formal education

Spouse Information

Last
Gomez
First
Cesar
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
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
Frank Gomez 01/17/1999 Mother GA/USA
Ilsi Garcia 09/18/1997 Mother 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
K. Aleman
Referred By
x776 Rebecca