RUI-MAR-67

Code
RUI-MAR-67
Mercy ID
V-02993-01
Encounter Date
01/28/2009
Last
Ruiz
First
Maria isabel
DOB
07/08/1967
County
Cobb
Street
1973 Leila St.
City
Austell
State
GA
Zip
30106-
Home
(770) 941-1919
Cell
(770) 633-6705
Work
(770) 745-4115
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family

Spouse Information

Last
Ruiz
First
Roberto
DOB
09/17/1964
Address
N/A
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
YES
Consentimiento De Participar
YES

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
Ernesto Dani Ruiz 03/21/2003 Parents GA/USA
Jose Carlos Garcia 07/04/1987 Parents GA/USA
Roberto Alex Ruiz 08/07/2001 Parents GA/USA
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
walk in-Zaida