JAI-MAR-63

Code
JAI-MAR-63
Mercy ID
V-01423-01
Encounter Date
11/19/2003
Last
Jaime
First
Maricela
DOB
02/03/1963
County
Hall
Street
912 Orchard Brook DR.
City
Gainsville
State
GA
Zip
30504-
Home
(770) 572-8874
Family Status
Adult coupie-no children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Osorio
First
Jose
DOB
08/11/1958
Address
N/A
Telephone
N/A
COB
Colombia
Home Owner
YES
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
Dana Espinoza 05/04/1984 N/A California
Jassel Espinoza 01/03/1982 N/A California
Nelson Espinoza 09/21/1987 N/A California
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
HIV/STD Consejero_Francisco de la Fuente