BED-GLO-54

Code
BED-GLO-54
Mercy ID
V-00046-01
Encounter Date
01/26/2000
Last
Bedoya
First
Gloria
DOB
02/04/1954
County
Gwinnett
Street
1070 Court Dr. # F
City
Duluth
State
GA
Zip
30096-
Cell
(678) 637-6694
Family Status
Single adult
COB
Colombia
Gender
Female
Housing
Single Family
Education Level
Some College

Spouse Information

Last
N/A
First
N/A
DOB
N/A
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
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
Angelica Maria 02/27/1974 Adulto/Casado GA/USA
Natalia Andrea 11/28/1978 Adulto/Casado GA/USA

Former Spouse 1 Information

Last
Gomez
First
Guillermo
DOB
02/10/1948
Telephone
N/A
COB
Colombia
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By
linea-juana