ENTREVISTA
ENTREVISTA
ENTREVISTA
N CASO
Dpto
Mpio
Ent
U. Receptora
Ao
Consecutivo
Fecha:
Hora:
Estacin
de
arrayanes
Lugar:
polica
los
Gorge
Segundo Nombre
Primer Apellido
Garzn
Segundo Apellido
Documento de Identidad
Alias
16
Edad: 3
Aos.
C.C
Gnero:
Lugar de nacimiento
Pas
otra
No.
Colombia
Profesin
Estado civil
Fecha de nacimiento:
Departamento
Oficio
soltero
Nivel educativo
Direccin residencia:
Carrera 2#30-35
D 1
Telfono
Telfono
Cundinamarca
Melgar
Municipio
Soacha
Bachiller
Direccin notificacin
Departamento
de
Comerciante
Telfono
colombia
Cundinamarca
Pas
11 389 450
7945401
Municipio
Soacha
SI
NO
Usa audfonos:
SI
NO
II. Relato.
Al establecer comunicacin con la persona referenciada, manifiesta lo siguiente con relacin a la presente
investigacin.
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Versin 18/11/05
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Utiliz medios tcnicos para el registro de la entrevista SI
NO
Cul?
Firmas:
Firma entrevistado
Nombre:
Nombre:
Versin 18/11/05
c.c.
Versin 18/11/05
Cargo: