EFTA00130094

FT19-03508-001

FORENSIC TOXICOLOGY REQUEST FORM

<table><thead><tr><th></th><th>Type:</th><th>Bld</th></tr></thead><tbody><tr><td>FT19-03508-001</td><td>Source:</td><td>Femoral</td></tr></tbody></table>

M.E. CASE #: M-19-019432

DATE OF DEATH: 08/10/2019 7:36 AM

NAME OF DECEDENT: Epstein, Jeffery
Age 66 Years
Race White
M×F

AUTOPSY
NO AUTOPSY (Exam)
PURSUANT TO LAW

MEDICAL EXAMINER: Dr.

ME EXAM DATE: 08/11/2019

INDICATED: □ NO □ YES ☑ YES
BASIC COMPREHENSIVE