GUT-RUB-82

Code
GUT-RUB-82
Mercy ID
V-00654-02
Encounter Date
08/21/2001
Last
Gutierrez
First
Ruben
DOB
07/14/1982
County
Fulton
Street
53 Cedar Run
City
Atlanta
State
GA
Zip
30350-
Home
(770) 294-0080
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Not Homeless
Education Level
High school graduate

Spouse Information

Last
Santana
First
Ivonne
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
SOLO
No
Court Mandated
No
Program Completed
YES
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
Miguel N/A Parents GA/USA
NOTES
Ivonne Santana no es su pareja, ella es la sobrina pero con ella fue con la que tuvo el problema.

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
F. Perez
Data Entry
K. Aleman
Referred By
Fulton