ESP-ERI-76

Code
ESP-ERI-76
Mercy ID
V-03104-01
Encounter Date
06/29/2009
Last
Espinoza
First
Erika
DOB
03/22/1976
County
Gwinnett
Street
1435 Boggs Rd.
City
Duluth
State
GA
Zip
30096-
Home
(678) 380-0144
Cell
(678) 380-9253
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Vocational/Technical

Spouse Information

Last
Topete
First
Jorge
DOB
05/18/1973
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

Children

NAME DOB LIVING WITH STATE/COUNTRY
Giselle I Topete 01/13/2003 Mother GA/USA
Jazmin A. Topete 10/27/2000 Mother GA/USA
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
Jeanett-PADV