BOS-KET-70

Code
BOS-KET-70
Mercy ID
V-01517-01
Encounter Date
03/08/2004
Last
Bosque
First
Ketsy
DOB
09/04/1970
County
Other
Street
some street in Puerto Rico
City
Some city
State
GA
Zip
00000-0000
Home
(787) 826-8124
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Other

Spouse Information

Last
Sublett
First
James
DOB
05/05/1955
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
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
No
Consentimiento De Participar
No

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

Children

NAME DOB LIVING WITH STATE/COUNTRY
James Sublett 07/01/1992 Mother GA/USA
Katherine Sublett 07/26/1995 Mother GA/USA
Lucas Sublett 10/09/1993 Mother GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
K. Aleman
Referred By
x1375 Damaryz