PER-JUA-79

Code
PER-JUA-79
Mercy ID
V-03227-02
Encounter Date
07/27/2010
Last
Perez
First
Juan angel
DOB
04/24/1979
County
Clayton
Street
307 Hemmingway Place
City
Riverdale
State
GA
Zip
30274-
Cell
(770) 572-1143
Family Status
Single adult
COB
Mexico
Gender
Male
Housing
Single Family
Education Level
Some College

Spouse Information

Last
Gomez
First
Gwendolyne
DOB
11/24/1979
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
YES
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
Dayanara Perez 04/14/2006 Mother GA/USA
NOTES

Media Authoritation

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