BUS-EMA-70

Code
BUS-EMA-70
Mercy ID
V-00173-01
Encounter Date
04/12/2000
Last
Bustos
First
Ema
DOB
04/19/1970
County
Cobb
Street
2982 Barry av
City
Smyrna
State
GA
Zip
30082-
Home
(770) 438-6125
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Bustos
First
Angel
DOB
08/02/1963
Address
atlanta rd south cobb smyrna
Telephone
N/A
COB
Mexico
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

Children

NAME DOB LIVING WITH STATE/COUNTRY
alicia bustos 06/21/1993 Mother GA/USA
luis antonio bustos 01/13/1995 Mother GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
D. Gomez
Referred By