GUT-ELE-70

Code
GUT-ELE-70
Mercy ID
V-00240-02
Encounter Date
06/13/2000
Last
Gutierrez
First
Eleodoro
DOB
04/25/1970
County
Fulton
Street
66 Northwood Dr Apt-105
City
Atlanta
State
GA
Zip
30342-
Home
(404) 459-9341
Family Status
Adult coupie-no children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Ramirez
First
Anahi
DOB
N/A
Address
same
Telephone
N/A
COB
Mexico
Home Owner
YES
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
YES
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
damali gutierrez 11/13/1993 Mother GA/USA
lesly gutierrez 12/08/1998 Grandparents GA/USA

Former Spouse 1 Information

Last
Petatan
First
Ana maria
DOB
N/A
Telephone
N/A
COB
N/A
Home Owner
No
NOTES
Damali y Lesly Gutierrez son hijas de su pareja anterior

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
R. Miranda
Data Entry
D. Gomez
Referred By
Fulton County