GAM-MAR-75

Code
GAM-MAR-75
Mercy ID
V-00589-01
Encounter Date
06/28/2001
Last
Gamez
First
Maria
DOB
08/06/1975
County
Dekalb
Street
680 Peachtree Ind. Blv.
City
Doraville
State
GA
Zip
30360-
Home
(770) 417-1892
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Flores
First
Manuel
DOB
05/14/1976
Address
N/A
Telephone
N/A
COB
El Salvador
Home Owner
YES
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
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
Carlos Bernar 01/02/1996 Parents GA/USA
Jonathan Flores 07/07/2000 Parents GA/USA
Luis Gamez 10/10/1997 Parents GA/USA
Manuel Flores 10/03/1998 Parents 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
K. Aleman
Referred By
x7764 Michelle Roman