IÑI-GRA-69

Code
IÑI-GRA-69
Mercy ID
V-02029-01
Encounter Date
09/15/2005
Last
Iñiguez
First
Graciela
DOB
09/10/1969
County
Gwinnett
Street
5987 Lanier Boulevard
City
Norcross
State
GA
Zip
30071-
Cell
(678) 887-5583
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Some College

Spouse Information

Last
Rios
First
Jose luis
DOB
08/18/1967
Address
W. construccion
Telephone
(404) 201-3553
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
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
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Bexaira Rios 05/27/2003 Parents GA/USA
Joselin Rios 09/11/1997 Parents GA/USA
Leslie Rios 09/25/1995 Parents GA/USA

Former Spouse 1 Information

Last
Rios
First
Jose luis
DOB
08/18/1967
Telephone
N/A
COB
N/A
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
YES
Limitado CL
No
Intake
J. Perez
Data Entry
R. Gonzalez
Referred By
linea-Griselda