GUT-JOH-81

Code
GUT-JOH-81
Mercy ID
V-02298-01
Encounter Date
08/10/2006
Last
Gutierrez
First
Johana
DOB
08/13/1981
County
Gwinnett
Street
1816 Coleville Cir.
City
Norcross
State
GA
Zip
30093-
Cell
(678) 768-1211
Family Status
Single parent w/children
COB
Honduras
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Tinoco sotelo
First
Ivan
DOB
06/28/2000
Address
N/A
Telephone
N/A
COB
USA
Home Owner
YES
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
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
Yasliz Gutierrez 12/07/2003 Mother GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
J. Manzo
Referred By
Susy Matorel& PADV