PER-GUA-76

Code
PER-GUA-76
Mercy ID
V-03525-01
Encounter Date
02/08/2011
Last
Perez
First
Guadalupe ii
DOB
12/12/1976
County
Dekalb
Street
3905 Mcelroy Rd.
City
Atlanta
State
GA
Zip
30340-
Cell
(678) 598-1525
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
High school graduate

Spouse Information

Last
Vazquez
First
Joaquin
DOB
07/26/1980
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
Angel Perez 12/17/1999 Mother w/Stepfather GA/USA
Eliana Perez 01/03/2005 Mother w/Stepfather GA/USA
Genesis Perez 03/22/1998 Mother w/Stepfather GA/USA
Rashel Perez 03/13/2002 Mother w/Stepfather GA/USA
NOTES

Media Authoritation

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