GON-DEJ-78

Code
GON-DEJ-78
Mercy ID
V-01753-01
Encounter Date
11/15/2004
Last
Gonzalez
First
De jesus maria
DOB
06/09/1978
County
Gwinnett
Street
5151-B Williams Rd.
City
Norcross
State
GA
Zip
30093-
Home
(770) 318-1950
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Guerrero
First
Mauricio
DOB
07/11/1968
Address
N/A
Telephone
(770) 318-1950
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
Ralph Cervantes 12/28/1998 Mother w/Stepfather GA/USA
Susan Guerrero 05/29/2003 Parents GA/USA
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
Meadow Creek