FLO-GLA-68

Code
FLO-GLA-68
Mercy ID
V-01401-01
Encounter Date
11/06/2003
Last
Flores
First
Gladys
DOB
01/11/1968
County
Dekalb
Street
211 Winter Park Dr.
City
Atlanta
State
GA
Zip
30360-
Home
(404) 312-2608
Family Status
Single parent w/children
COB
Ecuador
Gender
Female
Housing
Not Homeless
Education Level
Some College

Spouse Information

Last
Flores
First
Carlos
DOB
09/15/1956
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
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
YES
Consentimiento De Participar
YES

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
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
K. Aleman
Referred By