ESC-GRA-79

Code
ESC-GRA-79
Mercy ID
V-01952-01
Encounter Date
07/05/2005
Last
Escotorin
First
Graciela
DOB
01/03/1979
County
Forsyth
Street
6320 Glenbrooke
City
Cumming
State
GA
Zip
30040-
Home
(770) 844-6218
Family Status
Single parent w/children
COB
Argentina
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Abalos
First
Alejandro
DOB
N/A
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
Alanis Delira 03/16/2002 Mother 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
x1375 Jacqueline