Code
AND-ALI-71
Mercy ID
V-02475-01
Encounter Date
04/23/2007
Last
Andrade
First
Alicia
DOB
02/02/1971
County
Gwinnett
Street
4955 Northinglane
City
Snellville
State
GA
Zip
30039-
Cell
(404) 604-6431
Family Status
Two parent family w/children
COB
Honduras
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Padilla
First
Neftaly
DOB
11/17/1972
Address
N/A
Telephone
N/A
COB
N/A
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
DFACS County
Alcohol & Drug
No
# of DUIs
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
Driver License Date
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
GianCarlos Padilla N/A Parents GA/USA
Jose Martinez N/A Mother w/Stepfather GA/USA
NOTES

Media Authoritation

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