GON-FRA-69

Code
GON-FRA-69
Mercy ID
V-00077-02
Encounter Date
08/20/1999
Last
Gonzalez
First
Francisco
DOB
12/30/1969
County
Dekalb
Street
3354 Burk Drive Apt. 49
City
Chamblee
State
GA
Zip
30341-
Home
(770) 458-6379
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Cortez
First
Elvira
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
SOLO
No
Court Mandated
No
Program Completed
YES
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
Ariel N/A Parents GA/USA
Briseida N/A Parents GA/USA
Francisco N/A Parents GA/USA
Rosalinda N/A Parents GA/USA
NOTES

Media Authoritation

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