Code
BEL-JON-89
Mercy ID
V-00753-21
Encounter Date
12/05/2001
Last
Beltran
First
Jonathan
DOB
08/12/1989
County
Gwinnett
Street
772 River Landing Dr.
City
Lawrenceville
State
GA
Zip
30045-
Home
(770) 682-8853
Family Status
Attached youth
COB
Puerto Rico
Gender
Male Child
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
N/A
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
DFACS County
Alcohol & Drug
No
# of DUIs
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
Driver License Date
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
Y. Garcia
Data Entry
K. Aleman
Referred By