GUI-MAR-72

Code
GUI-MAR-72
Mercy ID
V-01440-01
Encounter Date
12/11/2003
Last
Guillen
First
Maria
DOB
06/09/1972
County
Fulton
Street
390 Erwing ST.
City
Atlanta
State
GA
Zip
30312-
Home
(404) 522-3188
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
N/A
First
N/A
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
No
Consentimiento De Participar
No

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

Children

NAME DOB LIVING WITH STATE/COUNTRY
Jessica Janet Cuevas 08/30/1990 Parents GA/USA
Rafael Cuevas 08/24/1992 Parents GA/USA
Uriel Cuevas 10/30/1994 Parents GA/USA
Uvaldo 04/22/1992 Parents GA/USA
NOTES

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