GAL-ANA-54

Code
GAL-ANA-54
Mercy ID
V-00664-01
Encounter Date
09/04/2001
Last
Galeas
First
Ana rosa
DOB
07/26/1954
County
Gwinnett
Street
1893 Guardian Way
City
Lawrenceville
State
GA
Zip
30343-
Home
(678) 377-3072
Family Status
Two parent family w/children
COB
Honduras
Gender
Female
Housing
Doubling Up
Education Level
College Degree

Spouse Information

Last
Vivas
First
Juan
DOB
11/24/1961
Address
N/A
Telephone
N/A
COB
Nicaragua
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
Carlos Andres Vivas 06/28/1992 Parents GA/USA
Jasmil N/A Father w/Stepmother GA/USA
Violeta N/A Father w/Stepmother 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 Alba