RUI-FAN-67

Code
RUI-FAN-67
Mercy ID
V-00534-01
Encounter Date
05/22/2001
Last
Ruiz
First
Fanny
DOB
03/28/1967
County
Cobb
Street
3122 North Place Way
City
Smyrna
State
GA
Zip
30080-
Home
(770) 438-8620
Family Status
Two parent family w/children
COB
Venezuela
Gender
Female
Housing
Not Homeless
Education Level
Vocational/Technical

Spouse Information

Last
Delgado
First
Fernando
Middle
02106
DOB
02/10/1962
Address
N/A
Telephone
N/A
COB
Venezuela
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
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
K. Aleman
Referred By
Julia Perilla