GON-MAR-78

Code
GON-MAR-78
Mercy ID
V-01137-01
Encounter Date
02/20/2003
Last
Gonzalez
First
Marisol
DOB
01/08/1978
County
Dekalb
Street
000 some street
City
Some city
State
GA
Zip
00000-0000
Home
(404) 641-3317
Cell
(000) 000-0000
Family Status
Single parent w/children
COB
Dominican Rep
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Gutierrez
First
Roman
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
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
Careline Hernandez 04/09/2000 Mother GA/USA
Harlinne Gonzalez 02/01/1994 N/A New York
NOTES
She didn't want to give any information

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
Her partner