FAV-GRI-73

Code
FAV-GRI-73
Mercy ID
V-01835-01
Encounter Date
02/17/2005
Last
Hernandez
First
Griselda
DOB
09/19/1973
County
Gwinnett
Street
400 Stone Hill Dr.
City
Stone mountain
State
GA
Zip
00000-0000
Home
(770) 498-1434
Cell
(678) 789-2280
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Hernandez
First
Juan
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
YES
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Antonio de Jesus Hernandez 02/23/1994 Parents GA/USA
Iris Azucena Hernandez 12/31/1997 Parents GA/USA
NOTES
On 4/13/05 Griselda requested that her last name be changed to Hernandez. Formerly known as Favela

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
K. Aleman
Referred By