GON-MON-76

Code
GON-MON-76
Mercy ID
V-01234-01
Encounter Date
05/21/2003
Last
Gonzalez
First
Monica
DOB
10/07/1976
County
Gwinnett
Street
1745 Racket Club Dr.
City
Lawrenceville
State
GA
Zip
30043-
Home
(678) 377-9241
Family Status
Adult coupie-no children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
Some College

Spouse Information

Last
Gonzalez
First
John
DOB
03/11/1967
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
No
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No
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
Friend Ruby