BUS-WIL-83

Code
BUS-WIL-83
Mercy ID
V-02571-02
Encounter Date
04/29/2008
Last
Bustamante
First
William
DOB
12/22/1983
County
Dekalb
Street
4499 Lawrenceville
City
Tucker
State
GA
Zip
30084-
Cell
(770) 820-3106
Family Status
Adult couple-no children
COB
Honduras
Gender
Male
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Mustafa
First
Shannon
DOB
02/08/1973
Address
N/A
Telephone
N/A
COB
USA
Home Owner
YES
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
No
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
J. Manzo
Data Entry
J. Manzo
Referred By
internet esposa