CRU-PED-56

Code
CRU-PED-56
Mercy ID
B-00048-02
Encounter Date
06/03/1998
Last
Cruz
First
Pedro
DOB
06/26/1956
County
Dekalb
Street
4391 Highland Rd.
City
Decatur
State
GA
Zip
30035-
Home
(404) 286-4021
Family Status
Unknow/Unreported
COB
Puerto Rico
Gender
Male

Spouse Information

Last
Lynnette
First
Betancourt
DOB
N/A
Address
N/A
Telephone
N/A
COB
Puerto Rico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
YES
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
Kaliomara Cruz N/A N/A GA/USA
Pedro Cruz N/A N/A GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
F. Perez
Data Entry
K. Aleman
Referred By