PER-ERI-83

Code
PER-ERI-83
Mercy ID
V-01883-01
Encounter Date
04/25/2005
Last
Perez
First
Erica martha
DOB
02/25/1983
County
Gwinnett
Street
1267 Phonix Dr.
City
Not given
State
GA
Zip
00000-0000
Home
(770) 381-3927
Cell
(770) 921-2474
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Tapia
First
Guillermo
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
YES
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
Bryan Tapia 09/30/2004 Parents GA/USA
Byron Tapia 11/15/2001 Parents 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
Damarys