Code
JUA-LUC-61
Mercy ID
V-02163-01
Encounter Date
02/07/2006
Last
Juares
First
Lucila
DOB
09/17/1961
County
Fulton
Street
3102 Dogwood Dr
City
Happeville
State
GA
Zip
30354-
Home
(770) 446-2748
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Juares
First
Manuel
DOB
02/28/1960
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
No
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

Children

NAME DOB LIVING WITH STATE/COUNTRY
Benda Juarez 10/05/1992 Mother GA/USA
Daniel Juarez 10/09/1987 Mother GA/USA
Luis Carlos Juarez 03/29/1986 Mother GA/USA
Omar Juarez 04/27/1999 Mother GA/USA
Rene Juarez 01/16/1991 Mother GA/USA
Victor M. Juarez 04/18/1984 Mother GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
R. Gonzalez
Referred By