EFTA00134578

## Inmate Name: EPSTEIN, JEFFREY EDWARD

### Date of Birth: 01/20/1953
### Encounter Date: 08/10/2019 07:25

### Exam:
ASSESSMENT:
Cardiac Arrest

## PLAN:

### New Consultation Requests:
- **Consultation/Procedure**: Emergency Room
  - Target Date: 08/10/2019
  - Scheduled Target Date: 08/10/2019
  - Priority: Emergent
  - Translator: No
  - Language:

### Subtype:
- **AMBULANCE**

### Reason for Request:
- Cardiac arrest with CPR in progress

### Copay Required: No
### Cosign Required: Yes

### Telephone/Verbal Order: No

Completed by [Name] RN on 08/10/2019 08:10

Requested to be cosigned by Beaudouin, Robert MD.

Cosign documentation will be displayed on the following page.

Generated on 08/10/2019 08:10 by [Name] RN
Bureau of Prisons - NYM



EFTA_00000039