GON-ADE-63

Code
GON-ADE-63
Mercy ID
V-00641-01
Encounter Date
08/07/2001
Last
Gonzalez
First
Adela
DOB
08/21/1963
County
Dekalb
Street
2795 Evans Mills Rd. A-26-6
City
Lithonia
State
GA
Zip
30058-
Home
(770) 482-2149
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Adult, no formal education

Spouse Information

Last
Gomez
First
Javier
DOB
08/18/1963
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
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
Daniela 01/12/1995 Grandmother Mexico
Francisco 09/19/1996 Grandmother Mexico
Maria Guadalupe 02/17/1986 Grandmother Mexico
Marisol 04/22/1984 Grandmother Mexico
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 Michelle Roman