HER-MAR-64

Code
HER-MAR-64
Mercy ID
V-01057-01
Encounter Date
12/18/2002
Last
Hernandez
First
Maria
DOB
04/28/1964
County
Gwinnett
Street
107 Brittany Cr
City
Duluth
State
GA
Zip
30096-
Home
(770) 232-7514
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
High school graduate

Spouse Information

Last
Vera
First
Mario
DOB
12/02/1962
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
Kimberly Vera 03/27/1997 Mother GA/USA
Mario Vera 01/25/1988 Mother GA/USA
Melissa Vera 04/01/1993 Mother GA/USA
Suset Vera 09/07/1983 Father 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
Y. Garcia
Referred By
Rebeca 7764