PAL-GLA-71

Code
PAL-GLA-71
Mercy ID
V-00602-01
Encounter Date
07/16/2001
Last
Palacios
First
Gladis
DOB
07/26/1971
County
Gwinnett
Street
1355 Graves Rd. Apt. 142
City
Norcross
State
GA
Zip
30093-
Home
(770) 938-6092
Family Status
Two parent family w/children
COB
Guatemala
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Lopez
First
Leonel
DOB
04/01/1971
Address
N/A
Telephone
N/A
COB
Honduras
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
Alexander Lopez 03/04/1996 Parents GA/USA
Estevan Castro 01/13/1989 Father California
Lester Lopez 06/17/1997 Parents GA/USA
Rodolfo Palacios 07/27/1985 Mother w/Stepfather 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
K. Aleman
Referred By
x7764 Michelle