GON-JES-96

Code
GON-JES-96
Mercy ID
V-01466-12
Encounter Date
01/14/2004
Last
Gonzalez
First
Jessica
DOB
08/22/1996
County
Gwinnett
Street
6259 Soul Norcross Tucker Rd. Apt. M-1
City
Tucker
State
GA
Zip
30084-
Cell
(404) 227-8390
Family Status
Child/Youth
COB
Mexico
Gender
Female Child
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
N/A
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
NOTES
Soplo en el corazon. No puede correr, ni levantar cosas pesadas.

Media Authoritation

NO DOY PERMISO
DOY PERMISO
YES
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
Y. Garcia
Data Entry
K. Aleman
Referred By