GON-EUS-70

Code
GON-EUS-70
Mercy ID
V-02833-02
Encounter Date
07/01/2008
Last
Gonzalez
First
Eusebio
DOB
06/27/1970
County
Gwinnett
Street
2874 Wildflower lane
City
Snellville
State
GA
Zip
30039-
Cell
(770) 896-2483
Family Status
Single adult
COB
Mexico
Gender
Male
Housing
Other
Education Level
Grade school

Spouse Information

Last
Elorza
First
Constantina
DOB
03/11/1973
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
YES
Court Mandated
YES
Program Completed
YES
DFCS Mandated
No
Alcohol & Drug
YES
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
YES
Mutual
No
Driver
No
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
Abisaid Gonzalez N/A Mother GA/USA
Ariana Elorza N/A Mother GA/USA
Griselda Gonzalez N/A Mother GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
J. Manzo
Referred By
Gwinnett court