HER-CEL-68

Code
HER-CEL-68
Mercy ID
V-02435-01
Encounter Date
03/12/2007
Last
Herrera
First
Celia
DOB
01/20/1968
County
Dekalb
Street
3329 Buford Hwy I-2
City
Atlanta
State
GA
Zip
30329-
Cell
(678) 858-0730
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Antonio
First
Martin
DOB
06/18/1978
Address
N/A
Telephone
(678) 858-9019
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
Abigail Gutierrez 09/08/1997 Mother w/Stepfather GA/USA
Alexis Antonio 01/03/2007 Parents GA/USA
Alfredo Gutierrez 07/29/1999 Mother w/Stepfather GA/USA
Fernanda Gutierrez 09/28/1995 Mother w/Stepfather GA/USA
Humberto Gutierrez 03/31/1994 Mother w/Stepfather GA/USA
Jorge Antonio 08/02/2005 Parents GA/USA
Kelvin Antonio 06/02/2004 Parents GA/USA
NOTES
No se hizo 00. A.R. solo follow up 2008. No se hizo contacto.

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
Felipe