Promotoria de Una

TRIAGEM N ____________

Data: ______/_____/2009 Horrio: ______________

Nome: ___________________________________________________ RG _________________________

Estado civil: _______________ Profisso: _______________________ Nascimento: _________________
Endereo: _____________________________________________________________________________
Bairro: _____________________________ Cidade: __________________________ Estado: __________
Telefone(s): ( ) Residencial: _____________( ) Trabalho: _____________( ) Celular : ______________
RESUMO DOS FATOS: _________________________________________________________________
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Notificado(a)/convidado(a): ____________________________________________________________
Endereo: __________________________________________________________________________
Bairro: ____________________________ Tel.: ____________________ Cidade: _________________
Marcado para o dia: _____/_____/2013, s _____h______ min.
Estagirio(a): _______________________ Promotor(a) de Justia: Dr(a). _______________________
( ) Compareceu - ( ) No compareceu.
Soluo: ____________________________________________________________________________
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