PUL-MAR-74

Code
PUL-MAR-74
Mercy ID
V-02063-01
Encounter Date
10/26/2005
Last
Pulido
First
Marhly
DOB
04/13/1974
County
Gwinnett
Street
1157 Park Forest
City
Lilburn
State
GA
Zip
30047-
Cell
(727) 645-9045
Other
(678) 707-9270
Family Status
Single adult
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Contreras
First
Yojhan
DOB
03/23/1977
Address
N/A
Telephone
N/A
COB
Venezuela
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

Children

NAME DOB LIVING WITH STATE/COUNTRY
Chenaia Contreras 10/05/1998 Parents GA/USA
Sharon Contreras 09/14/2003 Parents GA/USA

Former Spouse 1 Information

Last
Canales
First
Regulo
DOB
03/30/1985
Telephone
N/A
COB
N/A
Home Owner
YES
NOTES

Media Authoritation

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