GAL-FRA-53

Code
GAL-FRA-53
Mercy ID
V-02212-02
Encounter Date
04/03/2006
Last
Gallegos
First
Francisco a
DOB
01/04/1953
County
Gwinnett
Street
827 Ridge Trl
City
Duluth
State
GA
Zip
30096-
Home
(404) 578-4922
Family Status
Single adult
COB
Colombia
Gender
Male
Housing
Doubling Up
Education Level
H.S. equivalency diploma

Spouse Information

Last
Gallegos
First
Angela
DOB
06/09/1961
Address
N/A
Telephone
N/A
COB
Colombia
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
YES
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
Andrea 02/25/1985 Mother 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
Gwinnett County