ALD-MAR-63

Code
ALD-MAR-63
Mercy ID
V-02509-01
Encounter Date
06/06/2007
Last
Aldana
First
Maria
DOB
10/18/1963
County
Gwinnett
Street
1620 Purcel Rd. Lot 85
City
Lawrenceville
State
GA
Zip
30043-
Home
(770) 339-9885
Cell
(404) 789-6434
Family Status
Adult couple-no children
COB
El Salvador
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Hernandez
First
Jose
DOB
08/01/1976
Address
N/A
Telephone
N/A
COB
Guatemala
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
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
Ariel Gomez 03/15/1995 Grandmother El Salvador
Iris Abigail 08/21/1987 Grandmother El Salvador
Oseas Gomez 07/19/1990 Grandmother El Salvador

Former Spouse 1 Information

Last
Gomez
First
Francisco
DOB
04/08/1964
Telephone
N/A
COB
El Salvador
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By
walk in