CRU-ALM-70

Code
CRU-ALM-70
Mercy ID
V-00595-01
Encounter Date
07/11/2001
Last
Cruz
First
Alma
DOB
06/09/1970
County
Gwinnett
Street
320 Bethesda Park Dr.
City
Lawrenceville
State
GA
Zip
30044-
Home
(770) 638-9618
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up

Spouse Information

Last
Cruz
First
Hector
DOB
12/04/1971
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
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
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
Angie Melissa Cruz 03/09/1994 Parents GA/USA
Hector David Cruz 08/06/1997 Parents 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
K. Aleman
Referred By
x7764 Ma. Eugenia