EFTA00059506

# Bureau of Prisons
Health Services
Clinical Encounter - Administrative Note

| Inmate Name: | EPSTEIN, JEFFREY EDWARD |
| :--- | :--- |
| Date of Birth: | 01/20/1953 |
| Note Date: | 07/24/2019 16:10 |

| | |
| :--- | :--- |
| Sex: | M Race: WHITE |
| Provider: | MD |
| Reg #: | 76318-054 |
| Facility: | NYM |
| Unit: | H01 |



Cosign Note - Clinical Encounter Cosign encounter performed at Health Services. Administrative Notes:

ADMINISTRATIVE NOTE 1 Provider: MD

THE MLP NOTIFIED THE OP LT OF THE INMATE STATEMENT REGARDING WHAT HAPPENED TO HIM

2 NIGHTS AGO.

Copay Required: No



Cosign Required: No

Telephone/Verbal Order: No

Completed by MD on 07/24/2019 16:12

Generated 07/24/2019 16:12 bv

MD

Page 1 of 1

Bureau of Prisons - NYM

EFTA00059507

# Bureau of Prisons
Health Services
Clinical Encounter - Administrative Note

<table><tr><td>Inmate Name:</td><td colspan="4">EPSTEIN, JEFFREY EDWARD</td><td>Reg #:</td><td>76318-054</td></tr><tr><td>Date of Birth:</td><td>01/20/1953</td><td>Sex:</td><td>M</td><td>Race:WHITE</td><td>Facility:</td><td>NYM</td></tr><tr><td>Note Date:</td><td>07/24/2019 16:10</td><td>Provider:</td><td colspan="2"></td><td>Unit:</td><td>H01</td></tr></table>

Cosign Note - Clinical Encounter Cosign encounter performed at Health Services. Administrative Notes:

ADMINISTRATIVE NOTE 1 Provider: MD THE MLP NOTIFIED THE OP LT OF THE INMATE STATEMENT REGARDING WHAT HAPPENED TO HIM 2 NIGHTS AGO.

Copay Required:No

Cosign Required: No

Telephone/Verbal Order: No

Completed by MD on-07/24/2019 16:12

Generated 07/24/2019 16:12 by

MD

Page 1 of 1

Bureau of Prisons - NYM