MOR-GRI-81

Code
MOR-GRI-81
Mercy ID
V-02059-01
Encounter Date
10/12/2005
Last
Morales
First
Gricelia
DOB
06/21/1981
County
Dekalb
Street
3683 Buford Hwy Apt2
City
Atlanta
State
GA
Zip
30329-
Home
(404) 315-0139
Cell
(678) 608-9850
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
N/A
First
N/A
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
Gerardo Hernandez 01/21/2000 Mother GA/USA
Miguel Angel Hernandez 09/10/2001 Mother GA/USA
Victor Hernandez 11/17/2003 Mother GA/USA

Former Spouse 1 Information

Last
Hernandez
First
Genaro
DOB
09/19/1975
Telephone
(404) 315-6754
COB
N/A
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
R. Gonzalez
Referred By