HER-EFR-65

Code
HER-EFR-65
Mercy ID
V-00429-02
Encounter Date
02/27/2001
Last
Hernandez
First
Efren
DOB
10/19/1965
County
Fulton
Street
1135 Old Roswell Rd
City
Roswell
State
GA
Zip
30076-
Home
(770) 518-4317
Family Status
Adult coupie-no children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Hernandez
First
Sonia
DOB
02/07/1969
Address
same
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
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
Cristian Hernandez 06/01/1991 N/A GA/USA
Eric Hernandez 11/20/1994 N/A GA/USA
Erica Hernandez 07/18/1990 N/A GA/USA
NOTES

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
DHR Cherokee County