HER-LID-61

Code
HER-LID-61
Mercy ID
V-01877-01
Encounter Date
04/11/2005
Last
Hernandez
First
Lidia
DOB
06/08/1961
County
Fulton
Street
300 Carpenter Dr.
City
Atlanta
State
GA
Zip
30328-
Cell
(404) 399-0367
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Gonzalez
First
Enrique
DOB
04/30/1976
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
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
Adriana Gonzalez 09/22/1994 Parents GA/USA
Blanca Gonzalez 06/06/1996 Parents GA/USA
Mariana Bustos 12/24/1985 Adulto/Casado 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