BOL-NUJ-92

Code
BOL-NUJ-92
Mercy ID
V-02663-21
Encounter Date
12/12/2007
Last
Bolivar
First
Nujad
DOB
07/21/1992
County
Cobb
Street
2916 Mason Wood
City
Kennesaw
State
GA
Zip
30152-
Cell
(678) 522-0776
Family Status
Child/Youth
COB
Colombia
Gender
Male Child
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
N/A
Home Owner
No
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
C. Martinez
Data Entry
J. Manzo
Referred By