Code
CHO-EVE-94
Mercy ID
V-01886-21
Encounter Date
04/02/2008
Last
Chonay
First
Ever
DOB
04/19/1994
County
Gwinnett
Street
4498 Buford Hwy Lot 203
City
Norcross
State
GA
Zip
30071-
Cell
(678) 755-8251
Family Status
Child/Youth
COB
USA
Gender
Male Child
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
N/A
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
DFACS County
Alcohol & Drug
No
# of DUIs
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
Driver License Date
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
C. Alvarado
Data Entry
J. Manzo
Referred By