EFTA00059508¶
Bureau of Prisons Health Services See Amendment¶
Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Encounter Date: 07/26/2019 08:57¶
Reg #: 76318-054 Race: WHITE Facility: NYM¶
Amendment made to this note by MD on 07/26/2019 08:58.¶
Bureau of Prisons¶
Health Services Clinical Encounter - Administrative Note¶
| Inmate Name: | EPSTEIN, JEFFREY EDWARD | Reg #: | 76318-054 | |||
|---|---|---|---|---|---|---|
| Date of Birth: | 01/20/1953 | Sex: | M | Race:WHITE | Facility: | NYM |
| Note Date: | 07/24/2019 15:10 | Provider: | Unit: | H01 | ||
Admin Note - General Administrative Note encounter performed at Health Services.¶
Administrative Notes:¶
Copay Required:No¶
ADMINISTRATIVE NOTE 1 Provider: MD¶
PATIENT WAS OFFERED TO HAVE AN OPTOMETRIST EVALUATION. HE REFUSED. REFUSAL FORM SIGNED.¶
Telephone/Verbal Order: No¶
Cosign Required: No¶
Completed by MD on 07/24/2019 15:17¶
Generated 07/24/2019 15:17 by¶
MD¶
Page 1 of 1¶
Bureau of Prisons - NYM¶