GON-JOS-77

Code
GON-JOS-77
Mercy ID
V-00078-02
Encounter Date
08/20/1999
Last
Gonzalez
First
Jose
DOB
12/12/1977
County
Cherokee
Street
1212 Hwy92 #34
City
Acworth
State
GA
Zip
30102-
Family Status
Two parent family w/children
COB
Guatemala
Gender
Male
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Solis
First
Amy
DOB
10/11/1970
Address
same
Telephone
N/A
COB
Guatemala
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
Elijah Catano 12/13/1988 Mother GA/USA
Isiah R Catano 02/13/1991 Mother GA/USA
Matthew X Solis 01/19/1990 Mother 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
D. Gomez
Referred By