VIL-GLA-85

Code
VIL-GLA-85
Mercy ID
V-03153-01
Encounter Date
08/25/2009
Last
Villa
First
Gladys
DOB
08/02/1985
County
Dekalb
Street
2589-B New Bedford Way
City
Atlanta
State
GA
Zip
30345-
Cell
(678) 595-5875
Family Status
Two parent family w/children
COB
Ecuador
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Juarez
First
Cresencio
DOB
05/31/1983
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
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
Axel Juarez 05/21/2008 Parents 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