GON-OMA-65

Code
GON-OMA-65
Mercy ID
V-02897-01
Encounter Date
10/01/2008
Last
Gonzalez
First
Omaira
DOB
01/22/1965
County
Walton
Street
341 Meadows Drive
City
Loganville
State
GA
Zip
30052-
Cell
(678) 925-5879
Family Status
Single parent w/children
COB
Colombia
Gender
Female
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Franco
First
Andre
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
YES
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
No
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
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