CRU-ENR-67

Code
CRU-ENR-67
Mercy ID
V-01951-02
Encounter Date
07/26/2005
Last
Cruz
First
Enrique
DOB
07/16/1967
County
Cobb
Street
6780 Mableton Pkwy Lot 81
City
Mableton
State
GA
Zip
30126-
Home
(770) 948-5634
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Abarca
First
Bertha
DOB
12/25/1958
Address
N/A
Telephone
(770) 948-5634
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
YES
Program Completed
YES
DFCS Mandated
No
Alcohol & Drug
No
Partner Referred to Tepestri
No
Recidivism/Court
YES
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
Enrique Rogelio 03/29/1988 Father GA/USA
Francis Abarca 04/14/1996 Mother GA/USA
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