DIA-OSW-73

Code
DIA-OSW-73
Mercy ID
V-02205-02
Encounter Date
03/27/2006
Last
Diaz
First
Oswaldo
DOB
09/27/1973
County
Gwinnett
Street
212 Briarlake
City
Atlanta
State
GA
Zip
30345-
Home
(770) 414-4626
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
Some College

Spouse Information

Last
Gutierrez
First
Rocio
DOB
08/12/1979
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
Edwin Alan Diaz Gutierrez 11/24/2002 Parents GA/USA
Jorge Oswaldo Diaz Gutierrez 04/24/1999 Parents GA/USA
Mirella Gutierrez 03/12/1996 Grandmother GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
F. Perez
Data Entry
R. Gonzalez
Referred By
Fabiola Gomez