FRI-SUS-62

Code
FRI-SUS-62
Mercy ID
V-02774-01
Encounter Date
05/02/2008
Last
Fritschi
First
Susana
DOB
11/12/1962
County
Gwinnett
Street
2410 Coweta Road
City
Dacula
State
GA
Zip
30019-
Cell
(678) 851-0748
Family Status
Adult couple-no children
COB
Uruguay
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Fritschi
First
Rafael
DOB
11/18/1950
Address
N/A
Telephone
N/A
COB
Perú
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

Former Spouse 1 Information

Last
N/A
First
Wilson
DOB
N/A
Telephone
N/A
COB
Uruguay
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
linea-Juana