GON-ELI-58

Code
GON-ELI-58
Mercy ID
V-01958-01
Encounter Date
07/01/2005
Last
Gonzalez
First
Elizabeth
DOB
02/14/1958
County
Gwinnett
Street
not given
City
Norcross
State
GA
Zip
00000-0000
Home
(404) 446-6558
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless

Spouse Information

Last
Gonzalez
First
Edgar
DOB
N/A
Address
N/A
Telephone
N/A
COB
Perú
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
Dax Gonzalez N/A Parents GA/USA
Edgar Gonzalez N/A 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