LOP-GER-71

Code
LOP-GER-71
Mercy ID
V-00813-01
Encounter Date
01/29/2002
Last
Lopez
First
Gertrudis
DOB
08/25/1971
County
Gwinnett
Street
2010 Harrison Ridge Ct.
City
Lawrenceville
State
GA
Zip
30044-
Home
(770) 338-9630
Family Status
Two parent family w/children
COB
Dominican Rep
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Lopez
First
Antony
DOB
12/18/1973
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
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
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
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Antony Lopez 09/16/1944 Parents GA/USA
Jeudy 09/14/2000 Parents 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
Ma. Eugenia