GAL-ANA-72

Code
GAL-ANA-72
Mercy ID
V-02083-01
Encounter Date
11/08/2005
Last
Gallegos
First
Ana
DOB
11/22/1972
County
Dekalb
Street
1402 Regency Woods Dr.
City
Atlanta
State
GA
Zip
30319-
Home
(404) 321-5288
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Reyes
First
Juan
DOB
04/30/1968
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
Diana Reyes 05/01/1992 Parents GA/USA
Hugo Reyes 05/26/1990 Parents GA/USA
Joshua Reyes 09/19/2002 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
R. Gonzalez
Referred By