GON-ROS-74

Code
GON-ROS-74
Mercy ID
V-02318-01
Encounter Date
09/05/2006
Last
Gonzalez
First
Rosa
DOB
09/13/1974
County
Gwinnett
Street
1525 Gordon Smith
City
Lawrenceville
State
GA
Zip
30095-
Home
(678) 886-0020
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Some College

Spouse Information

Last
Morga
First
Humberto
DOB
N/A
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
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
Humberto Morga 07/27/2004 Mother GA/USA
Jenifer Morga 07/27/2005 Mother GA/USA
Noel Ramos 11/28/1999 Mother 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
J. Manzo
Referred By
linea-juana