AVE-GUA-65

Code
AVE-GUA-65
Mercy ID
V-01708-01
Encounter Date
09/21/2004
Last
Avellaneda
First
Guadalupe
DOB
05/06/1965
County
Cobb
Street
540 Mobile Ln. Way
City
Marietta
State
GA
Zip
30008-
Home
(678) 471-5234
Family Status
Adult coupie-no children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Calles
First
Arcadio
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
YES
Consentimiento De Participar
YES

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
Angela G. Avellaneda N/A Father GA/USA
Felix Palazuelos 11/29/2001 DFACS GA/USA
Luis D. Palazuelos 02/08/1999 DFACS GA/USA
Miguel A. Avellaneda 05/04/1992 Father 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
x1375 Damaryz