GUT-ROS-69

Code
GUT-ROS-69
Mercy ID
V-00382-01
Encounter Date
01/09/2001
Last
Gutierrez
First
Rosa maria
DOB
01/09/1969
County
Gwinnett
Street
6031 Hunt Club Rn
City
Norcross
State
GA
Zip
30093-
Home
(110) 248-1376
Family Status
Single adult
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Gutierrez
First
Gerardo
DOB
05/17/1957
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
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
Aurelio Gutierrez 09/19/1996 Mother GA/USA
Gerardo Gutierrez 06/09/1990 Mother GA/USA
Lizzette Gutierrez 05/05/1987 Mother GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
D. Gomez
Referred By
7764 Maria Eugenia