FON-GLO-62

Code
FON-GLO-62
Mercy ID
V-02345-01
Encounter Date
10/30/2006
Last
Fonseca
First
Gloria
DOB
01/03/1962
County
Cobb
Street
1550 Bell Ferry Rd.
City
Marietta
State
GA
Zip
30066-
Home
(678) 354-2680
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Fonseca
First
Jesus
DOB
01/03/1960
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
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
David Fonseca 07/29/1995 Parents GA/USA
Gloria Fonseca 02/27/1994 Parents GA/USA
Ricardo Fonseca 03/12/1989 Parents 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
Cobb Court-Monica