SIE-LIB-79

Code
SIE-LIB-79
Mercy ID
V-02202-01
Encounter Date
03/16/2006
Last
Sierra
First
Libia
DOB
01/19/1979
County
Gwinnett
Street
4953 Burns Rd NW
City
Lilburn
State
GA
Zip
30047-
Home
(770) 381-9949
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Adult, no formal education

Spouse Information

Last
Garcia
First
Vicente
DOB
01/23/1983
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
YES
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
Alexis David Garcia 03/26/2005 Parents GA/USA
Araceli Jasmin Medina 10/21/2002 Father GA/USA
Emily Garcia 09/20/2006 Parents GA/USA
Jose Angel Medina 11/15/2000 Father GA/USA
Juan Jesus Medina 01/31/1996 Father GA/USA

Former Spouse 1 Information

Last
Medina
First
Jjuan jesus
DOB
N/A
Telephone
N/A
COB
Mexicano
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
R. Gonzalez
Referred By
Linea