HER-CEL-67

Code
HER-CEL-67
Mercy ID
V-02145-01
Encounter Date
01/11/2006
Last
Herrera
First
Celiz
DOB
11/27/1967
County
Gwinnett
Street
311 Engle Drive
City
Tucker
State
GA
Zip
30084-
Home
(717) 638-5748
Cell
(770) 717-6285
Family Status
Adult coupie-no children
COB
El Salvador
Gender
Female
Housing
Doubling Up
Education Level
Adult, no formal education

Spouse Information

Last
Valles
First
Jose
DOB
02/03/1962
Address
N/A
Telephone
N/A
COB
El Salvador
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
Deisy Valles 02/24/1993 Parents GA/USA
Joseph Valles 10/28/1995 Parents GA/USA
Lorena Valles 01/03/2005 Parents GA/USA
Marvin Valles 03/15/1987 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
Jessica Parker