EFTA00110371¶
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 15:10 |
| Sex: M Race:WHITE |
|---|
| Provider: MD |
| Reg #: | 76318-054 |
|---|---|
| Facility: NYM | |
| Unit: H01 |
Admin Note - General Administrative Note encounter performed at Health Services.¶
Administrative Notes:¶
ADMINISTRATIVE NOTE 1 Provider: MD¶
PATIENT WAS OFFERED TO HAVE AN OPTOMETRIST EVALUATION. HE REFUSED. REFUSAL FORM SIGNED.¶
Copay Required: No¶
Cosign Required: No¶
Telephone/Verbal Order: No¶
Completed by MD on 07/24/2019 15:17¶
Generated 07/24/2019 15:17 by¶
Page 1 of 1¶
MD¶
Bureau of Prisons - NYM¶