MEN-IME-76

Code
MEN-IME-76
Mercy ID
V-02735-01
Encounter Date
03/24/2008
Last
Mendez
First
Imelda
DOB
02/20/1976
County
Gwinnett
Street
1355 Graves Road
City
Norcross
State
GA
Zip
30093-
Cell
(404) 397-8101
Family Status
Single adult
COB
Guatemala
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Garcia
First
Guillermo
DOB
02/18/1973
Address
N/A
Telephone
N/A
COB
Guatemala
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
YES
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
Angel Garcia 10/02/1997 Grandmother Guatemala - Materna
Berverly Mendez 02/12/1999 Grandmother Guatemala - Materna
Christopher 03/10/2005 Grandmother Guatemala - Materna
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