SOT-GIS-69

Code
SOT-GIS-69
Mercy ID
V-01955-01
Encounter Date
06/30/2005
Last
Soto
First
Gisela
DOB
05/26/1969
County
Dekalb
Street
not given
City
Doraville
State
GA
Zip
30340-
Home
(000) 000-0000
Family Status
Single adult
COB
Mexico
Gender
Female
Housing
Shelter
Education Level
High school graduate

Spouse Information

Last
Machado
First
Felipe
DOB
05/26/1968
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

Children

NAME DOB LIVING WITH STATE/COUNTRY
Luis Enrique Lucero 09/01/1992 N/A Panama
Ronaldo Machacho 11/25/1998 N/A Panama
NOTES

Media Authoritation

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