MUÑ-GEM-61

Code
MUÑ-GEM-61
Mercy ID
V-01101-01
Encounter Date
02/06/2003
Last
Muñoz
First
Gema
DOB
01/07/1961
County
Gwinnett
Street
4300 Jimmy Carter Blvd. Apt. #719
City
Norcross
State
GA
Zip
30093-
Home
(678) 754-8061
Cell
(770) 723-6712
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Netto
First
Toni
DOB
01/17/1962
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
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

Children

NAME DOB LIVING WITH STATE/COUNTRY
Diana Carolina 08/02/1986 N/A GA/USA
Natalia Marcela Cano 06/04/1984 N/A GA/USA
Vanessa 12/05/2000 N/A GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
K. Aleman
Referred By
x3737 Damaryz