GUT-ERA-77

Code
GUT-ERA-77
Mercy ID
V-02211-02
Encounter Date
04/03/2006
Last
Gutierrez
First
Erasmo
DOB
11/25/1977
County
Dekalb
Street
2761 Shallowford Rd Apt G
City
Chamblee
State
GA
Zip
30341-
Home
(770) 455-9915
Cell
(770) 885-2820
Family Status
Adult coupie-no children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Varela
First
Carmen
DOB
07/16/1978
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
YES
Program Completed
YES
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
Maximiliano 11/26/1998 Uncle Mexico
Patricia 05/17/1997 Uncle Mexico
NOTES

Media Authoritation

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