SAN-JOS-47

Code
SAN-JOS-47
Mercy ID
V-00611-01
Encounter Date
07/17/2001
Last
Sanchez
First
Josefina
DOB
10/19/1947
County
Gwinnett
Street
2140 Glenn Park Ct.
City
Lawrenceville
State
GA
Zip
30044-
Home
(770) 277-0836
Family Status
Single parent w/children
COB
Dominican Rep
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Sanchez
First
Jose
DOB
11/14/1941
Address
N/A
Telephone
N/A
COB
Dominican Rep
Home Owner
YES
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
Ana Jessenia 05/01/1974 Adulto/Casado GA/USA
Jose Manuel 04/15/1971 Adulto/Casado GA/USA
Karina 08/12/1972 Adulto/Casado 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
x7764 Ma. Eugenia