RAN-JOS-63

Code
RAN-JOS-63
Mercy ID
V-02264-02
Encounter Date
06/19/2006
Last
Rangel rivera
First
Jose
DOB
09/06/1963
County
Other
Street
not given
City
No dio
State
GA
Zip
00000-
Cell
(678) 463-2334
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Rangel
First
Maria
DOB
03/20/1958
Address
N/A
Telephone
(678) 446-7644
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
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
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
F. Perez
Data Entry
J. Manzo
Referred By
Pastora La Sagrada