SEG-JOS-72

Code
SEG-JOS-72
Mercy ID
V-02615-02
Encounter Date
10/21/2008
Last
Segura
First
Jose
DOB
03/16/1972
County
Gwinnett
Street
6660 Buckingham Ct.
City
Norcross
State
GA
Zip
30093-
Cell
(678) 520-9498
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Jaime
First
Zhenia
DOB
09/30/1973
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
YES
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
Edson Segura 05/26/1999 Father w/Stepmother GA/USA
Janet Segura 08/21/2004 Parents GA/USA
Jose Segura Jr. 08/10/2006 Parents GA/USA
NOTES

Media Authoritation

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