GAL-ARA-82

Code
GAL-ARA-82
Mercy ID
V-02720-01
Encounter Date
02/21/2008
Last
Galindo
First
Aracely
DOB
07/09/1982
County
Gwinnett
Street
636 Jackson Park Lane
City
Suwanee
State
GA
Zip
30024-
Cell
(404) 853-5130
Family Status
Single parent w/children
COB
Honduras
Gender
Female
Housing
Shelter
Education Level
Adult, no formal education

Spouse Information

Last
Larios
First
Marvin
DOB
10/28/1960
Address
N/A
Telephone
N/A
COB
El Salvador
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
YES
Consentimiento De Participar
YES

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

TPO
No
Stay Away Condition
No
Mutual
No
Driver
YES
As A Child
YES
Relative
YES
Stranger
No
As An Adult
YES
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Carlos Ayala 09/20/2003 Mother GA/USA
Rafael Ayala 09/20/2003 Mother GA/USA
Vin Daniel Larios 08/30/2005 Parents GA/USA

Former Spouse 1 Information

Last
Ayala
First
Carlos
DOB
06/01/1953
Telephone
N/A
COB
Mexico
Home Owner
No
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
linea-Juana