BUS-JAN-67

Code
BUS-JAN-67
Mercy ID
V-00007-01
Encounter Date
01/11/2000
Last
Busby
First
Janet
DOB
01/17/1967
County
Gwinnett
Street
2100 The Arbor Dr. Apt. 1720
City
Duluth
State
GA
Zip
30096-
Home
(678) 376-0532
Family Status
Adult coupie-no children
COB
Venezuela
Gender
Female
Housing
Doubling Up
Education Level
College Degree

Spouse Information

Last
Busby
First
William
DOB
12/01/1943
Address
2523 Lawrenceville Hwy Decatur Ga. 30033
Telephone
N/A
COB
EEUU
Home Owner
YES
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
YES
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
J. Manzo
Data Entry
K. Aleman
Referred By