JUA-MAN-60

Code
JUA-MAN-60
Mercy ID
V-02163-02
Encounter Date
03/20/2006
Last
Juarez
First
Manuel gabriel
DOB
02/28/1960
County
Fulton
Street
3102 Dogwood Dr
City
Hapeville
State
GA
Zip
30354-
Cell
(678) 859-3359
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Other
Education Level
College Degree

Spouse Information

Last
Juarez
First
Lucila
DOB
09/17/1961
Address
N/A
Telephone
N/A
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
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
Brenda Liliana 10/05/1992 Mother GA/USA
Daniel 10/09/1987 Mother GA/USA
David Alejandro 01/16/1990 Mother GA/USA
Luis Carlos 03/29/1986 Mother GA/USA
Omar 04/27/1999 Mother GA/USA
Victor Manuel 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
F. Perez
Data Entry
R. Gonzalez
Referred By