GUT-FLO-72

Code
GUT-FLO-72
Mercy ID
V-00065-01
Encounter Date
03/30/2000
Last
Gutierrez
First
Flora
DOB
09/27/1972
County
Fulton
Street
818-A Tahoe Run
City
Roswell
State
GA
Zip
30076-
Home
(770) 642-8313
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Hernandez
First
Jose
Middle
L.
DOB
N/A
Address
Lawrencevill, GA
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
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Eduardo Hernandez 09/18/1996 Grandparents Mexico
Jose Luis Hernandez 12/17/1999 Mother GA/USA
Verenice Hernandez 07/16/1995 Grandparents Mexico
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
Y. Garcia
Referred By