SOL-AMY-70

Code
SOL-AMY-70
Mercy ID
V-00078-01
Encounter Date
07/21/1999
Last
Soliz
First
Amy
DOB
10/11/1970
County
Cherokee
Street
1212 Hwy #34
City
Acworth
State
GA
Zip
30102-
Home
(713) 733-1312
Family Status
Two parent family w/children
COB
USA
Gender
Female
Housing
Other
Education Level
some high school

Spouse Information

Last
Gonzalez
First
Jose
DOB
12/12/1977
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
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
Catano Isiah 02/13/1991 N/A GA/USA
Soliz Matthew 01/19/1990 N/A GA/USA
NOTES

Media Authoritation

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