EST-GLO-72

Code
EST-GLO-72
Mercy ID
V-01838-01
Encounter Date
02/18/2005
Last
Estrada
First
Gloria
DOB
04/01/1972
County
Gwinnett
Street
4595 Rosemear Cr.
City
Norcross
State
GA
Zip
30093-
Home
(678) 768-7743
Cell
(770) 935-9589
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Transitional
Education Level
some high school

Spouse Information

Last
Bolaños
First
Gabriel
DOB
07/21/1968
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
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
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
Alison Bolaños 06/28/1990 Father GA/USA
Dan Bolaños 02/05/1989 Father GA/USA
Dulce Bolaños 02/05/1989 Father GA/USA
NOTES

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