REY-FAT-77

Code
REY-FAT-77
Mercy ID
V-00967-01
Encounter Date
07/02/2002
Last
Reyes
First
Fatima
DOB
05/14/1977
County
Gwinnett
Street
4610 Gold Creek Trl
City
Buford
State
GA
Zip
30518-
Home
(770) 932-3308
Family Status
Two parent family w/children
COB
Nicaragua
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Lopez
First
Jose angel
DOB
08/03/1955
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
YES
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. Perez
Data Entry
K. Aleman
Referred By
x7764 Rebecca