Place of Arrest:agq/a 65 1/ 4 047 - Scat, S>pirth Height; Ft: Countr of Birth 5 7 C'ti enship e -2-__c Current Ad4ress .5? 4-72-5-77ett- A14,A,cvxis-,- Ai/ Zip Code /470.2/ In: 7Pt Injuries / Medication Scarsjamks / Tattoos 1 Arraigned Y yN IN Rezeiv Sign Print Sentenc,d __Y Special