GAL-ARA-76

Code
GAL-ARA-76
Mercy ID
V-01947-01
Encounter Date
06/29/2005
Last
Gallegos
First
Araceli
DOB
05/07/1976
County
Dekalb
Street
IWH
City
Decatur
State
GA
Zip
00000-0000
Other
(404) 297-5753
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Shelter
Education Level
some high school

Spouse Information

Last
Gallegos
First
Jose dolores
DOB
04/09/1965
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
YES
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Jose Ivan Gallegos 05/10/1994 Mother GA/USA
Julio Cesar Gallegos 03/30/1997 Mother 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