HER-YES-85

Code
HER-YES-85
Mercy ID
V-03447-01
Encounter Date
10/06/2010
Last
Hernandez
First
Yessica
DOB
11/17/1985
County
Gwinnett
Street
732 Rockbridge Rd. NW
City
Lilburn
State
GA
Zip
30047-
Cell
(678) 542-6293
Other
(678) 452-0024
Family Status
Two parent family w/children
COB
El Salvador
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
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
Ana P. Rosa 02/27/2000 Mother w/Stepfather GA/USA
Mario F. Chavez 11/28/2008 Parents GA/USA
Valerie Chavez 06/30/2007 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
linea-Juana