HER-GIS-77

Code
HER-GIS-77
Mercy ID
V-01135-01
Encounter Date
02/14/2003
Last
Hernandez
First
Gisela
DOB
05/05/1977
County
Clayton
Street
1101 Knight Chase Dr.
City
Stockbridge
State
GA
Zip
30281-
Home
(678) 768-4834
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Estrada
First
Jose luis
DOB
N/A
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
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
David Estrada 06/27/2002 Mother GA/USA
Jesica 05/12/1998 Mother GA/USA
Miguel Angel Estrada 06/04/1997 Mother GA/USA
Rosa Estrada 01/18/1996 Mother 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
x3737 Damaryz