Code
RUB-ISR-83
Mercy ID
V-01672-02
Encounter Date
08/17/2004
Last
Rubio
First
Israel
DOB
05/29/1983
County
Fulton
Street
84 Guillingham Apt #1
City
Hapeville
State
GA
Zip
30354-
Home
(404) 762-7063
Family Status
Adult coupie-no children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
Preschool

Spouse Information

Last
Mauney
First
Amy
DOB
05/21/1976
Address
N/A
Telephone
N/A
COB
USA
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
YES
Program Completed
YES
DFCS Mandated
No
DFACS County
Alcohol & Drug
No
# of DUIs
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
Driver License Date
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
R. Miranda
Data Entry
K. Aleman
Referred By
Fulton