GON-PAU-76

Code
GON-PAU-76
Mercy ID
V-01727-01
Encounter Date
10/19/2004
Last
Gonzalez
First
Paula
DOB
01/26/1976
County
Dekalb
Street
Not given
City
Dalton
State
GA
Zip
00000-
Home
(770) 873-9951
Cell
(678) 789-7374
Other
(404) 634-2516
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Espinoza
First
Edgar isidoro
DOB
06/01/1984
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
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
YES
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
Gerardo Borja 08/26/1994 Mother GA/USA
Luis Borja 07/19/1993 Mother GA/USA
Yaslin Borja 08/16/1998 Mother GA/USA

Former Spouse 1 Information

Last
Borja
First
Juan
DOB
03/10/1974
Telephone
N/A
COB
Es de Mex
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
K. Aleman
Referred By
Damaryz