RIV-REY-54

Code
RIV-REY-54
Mercy ID
V-00110-01
Encounter Date
02/07/2000
Last
Rivera
First
Reyna
DOB
01/06/1954
County
Gwinnett
Street
4605 Friman Lane
City
Norcross
State
GA
Zip
30093-
Home
(770) 279-1594
Family Status
Adult coupie-no children
COB
Panamá
Gender
Female
Housing
Not Homeless
Education Level
Some College

Spouse Information

Last
Rivera
First
Jose
DOB
06/11/1949
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
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
YES
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
J. Perez
Data Entry
D. Gomez
Referred By