# Bureau of Prisons
Health Services
Vision Screens

<table><thead><tr><th colspan="4">Reg #: 76318-054</th><th colspan="5">Inmate Name: EPSTEIN, JEFFREY EDWARD</th></tr></thead><tbody><tr><td>Vision Screen on</td><td colspan="9">07/09/2019 12:52</td></tr><tr><td colspan="10">Blindness:</td></tr><tr><td>Distance Vision:</td><td colspan="4">OD: 20/100</td><td colspan="2">OS: 20/70</td><td colspan="3">OU:</td></tr><tr><td>Near Vision:</td><td colspan="4">OD:</td><td colspan="2">OS:</td><td colspan="3">OU:</td></tr><tr><td colspan="10">With Corrective</td></tr><tr><td>Distance Vision:</td><td colspan="4">OD:</td><td colspan="2">OS:</td><td colspan="3">OU:</td></tr><tr><td>Near Vision:</td><td colspan="4">OD:</td><td colspan="2">OS:</td><td colspan="3">OU:</td></tr><tr><td colspan="5">Present Glasses - Distance</td><td colspan="5">Refraction - Distance</td></tr><tr><td>Sphere</td><td>Cylinder</td><td>Axis</td><td>Add</td><td></td><td>Sphere</td><td>Cylinder</td><td>Axis</td><td>Add</td><td></td></tr><tr><td>R:</td><td></td><td></td><td></td><td></td><td>R:</td><td></td><td></td><td></td><td></td></tr><tr><td>L:</td><td></td><td></td><td></td><td></td><td>L:</td><td></td><td></td><td></td><td></td></tr></tbody></table>

Tonometry: R: L:

Comments: Needs evaluation with optometrist.

| Orig Entered: | 07/09/2019 12:54 EST |

| :--- | :--- |

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Bureau of Prisons - NYM

EFTA00140222

# Bureau of Prisons
Health Services
Immunizations

<table><thead><tr><th>Immunization</th><th>Immunization Date</th><th>Administered</th><th>Location</th><th>Dosage Drug Mfg.</th><th>Lot #</th><th>Exp Date</th></tr></thead><tbody><tr><td>Hepatitis A and B (TwinRx)</td><td></td><td>History Unknown</td><td></td><td></td><td></td><td></td></tr><tr><td>Orig Entered: 07/09/2019 12:51 EST</td><td></td><td>.MLP</td><td></td><td></td><td></td><td></td></tr><tr><td>Measles/Mumps/Rubella Series</td><td></td><td>History Unknown</td><td></td><td></td><td></td><td></td></tr><tr><td>Orig Entered: 07/09/2019 12:51 EST</td><td></td><td>.MLP</td><td></td><td></td><td></td><td></td></tr><tr><td>Smallpox Series</td><td></td><td>History Unknown</td><td></td><td></td><td></td><td></td></tr><tr><td>Orig Entered: 07/09/2019 12:51 EST</td><td></td><td>.MLP</td><td></td><td></td><td></td><td></td></tr><tr><td>Tetanus</td><td></td><td>History Unknown</td><td></td><td></td><td></td><td></td></tr><tr><td>Orig Entered: 07/09/2019 12:51 EST</td><td></td><td>.MLP</td><td></td><td></td><td></td><td></td></tr><tr><td>Varicella Series</td><td></td><td>History Unknown</td><td></td><td></td><td></td><td></td></tr><tr><td>Orig Entered: 07/09/2019 12:51 EST</td><td></td><td>.MLP</td><td></td><td></td><td></td><td></td></tr><tr><td>Total: 5</td><td></td><td></td><td></td><td></td><td></td><td></td></tr></tbody></table>

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Bureau of Prisons - NYM