CHA-GIL-76

Code
CHA-GIL-76
Mercy ID
V-00187-02
Encounter Date
04/25/2000
Last
Chavez
First
Gildardo
DOB
06/13/1976
County
Fulton
Street
201 Northwood Apt F-6 Dr
City
Atlanta
State
GA
Zip
30342-
Home
(404) 303-1505
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Vasquez
First
Ericelda
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
YES
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

Children

NAME DOB LIVING WITH STATE/COUNTRY
Medardo Vasquez 01/08/2000 Parents GA/USA
Raymundo Vasquez 04/15/1996 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
F. Perez
Data Entry
D. Gomez
Referred By