ESP-PAT-73

Code
ESP-PAT-73
Mercy ID
V-02184-01
Encounter Date
03/08/2006
Last
Espino
First
Patricia
DOB
12/21/1973
County
Gwinnett
Street
6485 Bannor Ln
City
Norcross
State
GA
Zip
30092-
Cell
(678) 886-4058
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Santiago
First
Jesus
DOB
12/07/1974
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
YES
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
Brayan Santiago 07/22/2004 Parents GA/USA
Carlos Santiago 08/11/1997 Parents GA/USA
Cristian Santiago 12/25/1993 Uncle 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
Fabiola Gomez