EFTA00134745

# Bureau of Prisons
Health Services
Clinical Encounter - Administrative Note

<table><thead><tr><th>Inmate Name:</th><td colspan="4">EPSTEIN, JEFFREY EDWARD</td><th>Reg #:</th><td>76318-054</td></tr></thead><tbody><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></td><td></td><td>Unit:</td><td>H01</td></tr></tbody></table>



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

ADMINISTRATIVE NOTE 1 Provider:

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 , Robert MD on 07/24/2019 16:12

Generated 07/24/2019 16:12 bv

Page 1 of 1

Bureau of Prisons - NYM



SDNY_00001002


EFTA_00000211

EFTA00134746

# 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 colspan="3">Provider:</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:

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 Robert MD on-07/24/2019 16:12

Generated 07/24/2019 16:12 by

Page 1 of 1

Bureau of Prisons - NYM



SDNY_00001003


EFTA_00000212