ROS-GRE-78

Code
ROS-GRE-78
Mercy ID
V-00035-02
Encounter Date
09/08/1999
Last
Ross
First
Gregory
DOB
12/29/1978
County
Fulton
Street
883 tahoe Way # I
City
Roswell
State
GA
Zip
30076-
Home
(770) 998-0664
Family Status
Adult coupie-no children
COB
USA
Gender
Male
Housing
Other
Education Level
Post Grad Degree

Spouse Information

Last
Sanchez
First
Susana
DOB
05/11/1979
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
No
Consentimiento De Participar
No

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

TPO
No
Stay Away Condition
No
Mutual
No
Driver
No
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perilla
Data Entry
D. Gomez
Referred By