JIM-JAS-81

Code
JIM-JAS-81
Mercy ID
V-03213-01
Encounter Date
11/25/2009
Last
Jimenez
First
Jasmin
DOB
03/10/1981
County
Gwinnett
Street
3400 Sweetwater Rd. Apt. 406
City
Lawrenceville
State
GA
Zip
30044-
Cell
(770) 896-1477
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Zenil
First
Fidel
DOB
09/15/1982
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
YES
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
Enrique Jimenez 08/09/1999 Mother w/Stepfather GA/USA
Jibran Jimenez 03/05/2007 Mother w/Stepfather 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
linea-Juana