Professional Documents
Culture Documents
1
JUZGADO DE LA FAMILIA, MUJER, NIÑEZ Y ADOLESCENCIA
OFICINA TÉCNICA
Causa______________________________________
H.C.No.____________________________________________
Fecha ____________________________________________
I DATOS DE IDENTIFICACION
Instrucción: Analfabeto ( ); Escolar (gr. ___); Colegio (curso ___) Superior (curso ___)
II MOTIVO DE CONSULTA
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Padres juntos, SI ( ); NO ( );
Padre fallecido ( ), Madre fallecida ( ),
Conflictos con el padre SI ( ), NO ( ), Conflictos con la madre SI ( ), NO ( ),
con otros familiares ( ).
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CALLE CHIMBORAZO
CAÑAR-CAÑAR
UNIDAD JUDICIAL No. 1
JUZGADO DE LA FAMILIA, MUJER, NIÑEZ Y ADOLESCENCIA
OFICINA TÉCNICA
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Otros:
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Antecedentes familiares:
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CALLE CHIMBORAZO
CAÑAR-CAÑAR
UNIDAD JUDICIAL No. 1
JUZGADO DE LA FAMILIA, MUJER, NIÑEZ Y ADOLESCENCIA
OFICINA TÉCNICA
Instintos: Conservados: SI ( ), NO ( ).
Lenguaje: Normal ( ), coherente ( ), incoherente ( ), dislálico ( ), disléxico ( ), afásico ( ),
lacónico ( ), verborreico ( ), tartamudeo ( ), otros______________________________
Datos complementarios__________________________________________________________________
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CALLE CHIMBORAZO
CAÑAR-CAÑAR
UNIDAD JUDICIAL No. 1
JUZGADO DE LA FAMILIA, MUJER, NIÑEZ Y ADOLESCENCIA
OFICINA TÉCNICA
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X RECOMENDACIONES
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Dr. Arturo Andrade Amoroso. M.Sc.
PSICOLOGO PERITO
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CALLE CHIMBORAZO
CAÑAR-CAÑAR