RUI-ROS-76

Code
RUI-ROS-76
Mercy ID
V-01322-01
Encounter Date
08/21/2003
Last
Ruiz
First
Rosa
DOB
01/12/1976
County
Other
Street
924 Peachtree Station Circle
City
Peachtree
State
GA
Zip
30269-
Home
(770) 632-9599
Family Status
Two parent family w/children
COB
El Salvador
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Sanchez
First
Jose
DOB
07/26/1975
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
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
Jose Sanchez N/A Mother w/Stepfather GA/USA
Lina Elizabeth Ruiz N/A Grandparents GA/USA
Monica Michelle Ruiz N/A Grandparents GA/USA
NOTES

Media Authoritation

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