WIL-PER-70

Code
WIL-PER-70
Mercy ID
V-03068-01
Encounter Date
05/12/2009
Last
William
First
Perla
DOB
07/12/1970
County
Gwinnett
Street
4266 Gray Raetor Cr.
City
Snellville
State
GA
Zip
30039-
Home
(770) 982-2988
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Some College

Spouse Information

Last
Willian
First
Jason
DOB
06/06/1974
Address
N/A
Telephone
N/A
COB
USA
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

Children

NAME DOB LIVING WITH STATE/COUNTRY
Esmeralda Tepoz 08/04/1997 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By
linea-Juana