URB-GUA-74

Code
URB-GUA-74
Mercy ID
V-00949-01
Encounter Date
06/12/2002
Last
Urbina
First
Guadalupe
DOB
08/17/1974
County
Gwinnett
Street
5182 Edgemoore Dr.
City
Norcross
State
GA
Zip
30071-
Home
(770) 446-8221
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Proa
First
Arturo
DOB
02/07/1972
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
Alejandro Proa 12/05/1993 Parents GA/USA
Evelyn Proa 06/17/2001 Parents GA/USA
Mayra Proa 07/20/1995 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
Griselda Urbina/Hermana