BUS-TER-74

Code
BUS-TER-74
Mercy ID
V-03515-02
Encounter Date
02/01/2011
Last
Bustos
First
Tereso
DOB
10/15/1974
County
Dekalb
Street
4633 Peachtree Pl. Parkway Apt. C
City
Doraville
State
GA
Zip
30360-
Cell
(678) 500-4840
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
Huerta
First
Victoria
DOB
02/28/1989
Address
N/A
Telephone
(678) 914-5418
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
YES
Program Completed
No
DFCS Mandated
No
Alcohol & Drug
YES
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
Alexis Bustos 03/05/2004 Parents GA/USA
Jesus Jonathan Bustos 07/23/2005 Parents GA/USA
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
Dekalb County/Linea-Juana