ZAP-MAR-79

Code
ZAP-MAR-79
Mercy ID
V-01893-01
Encounter Date
03/28/2005
Last
Zapata
First
Marisol
DOB
07/13/1979
County
Gwinnett
Street
602 Gwinnett Square Circle
City
Duluth
State
GA
Zip
30096-
Home
(770) 300-9612
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Reyes
First
Jose
DOB
04/05/1969
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
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
Javier Reyes 09/05/1997 Mother GA/USA
Jose Reyes 07/14/2000 Mother GA/USA
Monica Reyes 01/29/1995 Mother GA/USA
NOTES

Media Authoritation

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