PUG-WEN-84

Code
PUG-WEN-84
Mercy ID
V-02760-01
Encounter Date
04/14/2008
Last
Puga
First
Wendy
DOB
10/26/1984
County
Hall
Street
776 West Ave. Apt. 4
City
Gainsville
State
GA
Zip
30501-
Home
(770) 572-4215
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Quintero
First
Juan
Middle
C.
DOB
10/04/1983
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
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
Jasmin Quintero 12/18/2001 Mother GA/USA
Kimberly Quintero 05/28/2007 Mother GA/USA
Yoselyn Quintero 03/27/2006 Mother 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
linea-Juana