Epstein Secrets

care in last 33 days 72 Yes No U Papitil in-pabent HeepiW ED/ outpatient U •losp COA C Other. specify: J J Nursing hone/long teem care Hospice rickey Decedent's residence DAM AND HOUR Of MAIM: 08/10/2019 7:36 AM Unk INJURY: Date Time: AM PM AT WORK J YES U NO TYPE OF PLACE:Irk

INAC 0.10 ng/mL EMB-PINACA MDMB-FUBICA 0.10 ng/mL 5-fluoro-MMB-PINACA 0.050 ng/mL MDMB-FUBINACA/ EMB- 0.10 ng/mL 5-fluoro-NA-PIC 0.10 ng/mL FUBINACA 5-fluoro-QU-PINAC 0.10 nglmL MMB-CHMICA 0.10 ng/mL ADAMANTYL-FUBINACA 0.20 ng/mL MMB-CHMINACA 0.20 ng/mL ADMB-CHMINACA 0.10 ng/mL MMB-FUBI

r: O Recent hospitalizations or travel: if yes, where and when: O Dentist name/address): O Tattoos or scars (e.g., old surgery), describe: 0 Any Hospice care in last 30 days? If so, where: High blood pressure Heart problems Diabetes Seizures Lung problems Tuberculosis Tobacco use Brain infecti

AC 0.10 ng/mL EMB-PINACA MDMB-FUBICA 0.10 ng/na. 5-fluoro-MMB-PINACA 0.050 ng/mL MDMB-FUBINACA I EMB- 0.10 ng/mL 5-fluoro-NA-PIC 0.10 ng/mL FUBINACA 5-fluoro-QU-PINAC 0.10 ng/mL MMB-CHMICA 0.10 ng/mL ADAMANTYL-FUBINACA 0.20 ng/mL MMB-CHMINACA 0.20 ng/mL ADMB-CHMINACA 0.10 ng/mL MMB-FUBI

last 93 days Yes ijb• No u NO U. 0 Hospital In-patient Hospital ED/outpatient Hoop DOA Other specify: u U U Nursing harnMong term care Hospice facity Decedents resktence DATE AND HOUR OF DEATH: 08/10/2019 7:36 AM u Unk INJURY: Date Time: AM PM AT WORK U YES U NO TYPE OF PIACE

NAC 0.10 ng/mL EMB-PINACA MDMB-FUBICA 0.10 ng/mL 5-fluoro-MMB-PINACA 0.050 ng/mL MDMB-FUBINACA I EMB- 0.10 ng/mL 5-fluoro-NA-PIC 0.10 ng/mL FUBINACA 5-fluoro-QU-PINAC 0.10 ng/mL MMB-CHMICA 0.10 ng/mL ADAMANTYL-FUBINACA 0.20 ng/mL MMB-CHMINACA 0.20 ng/mL ADMB-CHMINACA 0.10 ng/mL MMB-FUBI