CAN-GLO-63

Code
CAN-GLO-63
Mercy ID
V-00745-01
Encounter Date
11/13/2001
Last
Cano
First
Gloria
DOB
09/24/1962
County
Dekalb
Street
3610 Bufford Hwy B-1
City
Atlanta
State
GA
Zip
30329-
Home
(404) 634-1438
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Sierra
First
Crisanto
DOB
10/25/1960
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
YES
Consentimiento De Participar
YES

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
Dilan Jesus Sierra 06/27/2000 Parents GA/USA
Gloria Suey Gallegos 12/03/1989 Grandmother GA/USA
Irvin Oronato Gallegos 07/07/1991 Grandmother Mexico
Juan Gallegos 01/18/1987 Grandmother Mexico
Merle Juridia Gallegos 11/13/1988 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
Mision/Walk-In