GAR-GUA-80

Code
GAR-GUA-80
Mercy ID
V-03513-01
Encounter Date
01/25/2011
Last
Garcia
First
Guadalupe
DOB
09/05/1980
County
Gwinnett
Street
3343 Holcomb Bridge Rd.
City
Norcross
State
GA
Zip
30092-
Cell
(678) 260-4395
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high 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
YES
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
Jasmin Padilla 01/06/2003 Mother GA/USA
Jennifer Padilla 08/02/2000 Mother GA/USA
Karina Padilla 09/11/2005 Mother GA/USA
Martha G. Lopez 03/31/2009 Aunt Sobrina de Guad.-Mama murio de Lupus

Former Spouse 1 Information

Last
Padilla
First
Othoniel
DOB
07/12/1969
Telephone
N/A
COB
Mexico
Home Owner
YES
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
YES
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By
cell-Griselda