GAL-MAR-62

Code
GAL-MAR-62
Mercy ID
V-01650-01
Encounter Date
07/13/2004
Last
Galvan
First
Maria guadalupe
DOB
02/12/1962
County
Fulton
Street
2131 Cambridge Ave.
City
College park
State
GA
Zip
30337-
Home
(404) 396-5482
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Gallegos
First
Juan
Middle
A.
DOB
12/18/1959
Address
N/A
Telephone
N/A
COB
Mexico
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
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
Areli Alina Gallegos 08/09/1988 Parents GA/USA
Maria Guadalupe Gallegos 01/31/1985 Parents 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
K. Aleman
Referred By
Rafael Miranda