GUI-SAN-77

Code
GUI-SAN-77
Mercy ID
V-01206-01
Encounter Date
04/28/2003
Last
Guillen
First
Sandra
DOB
07/20/1977
County
Dekalb
Street
6750 Peachtree Ind. Blv. #513
City
Doraville
State
GA
Zip
30360-
Cell
(770) 875-9703
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Cordoba
First
Jose
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
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
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Eunue Cordoba 08/26/2000 Mother GA/USA
Guadalupe Sanchez 02/10/2006 Mother GA/USA
Jade Guillen 10/22/2005 Aunt Tia es Sandra
Jose Cordoba 01/03/1997 Mother GA/USA
NOTES

Media Authoritation

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