Code
LUJ-ADR-74
Mercy ID
V-01711-01
Encounter Date
08/19/1974
Last
Lujan
First
Adriana
DOB
08/19/1974
County
Gwinnett
Street
1218 Indian Way
City
Lilburn
State
GA
Zip
30047-
Home
(404) 454-7924
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Zavaleta
First
Carlos
DOB
11/04/1968
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
DFACS County
Alcohol & Drug
No
# of DUIs
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
Driver License Date
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
Christopher Zavaleta 05/21/2001 Parents GA/USA
Emmanuel Zavaleta 01/28/1994 Parents GA/USA
Gladys Zavaleta 12/04/1994 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