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

hoto and verified that they correspond with the decedent that I have been authorized to remove. Released B : Released To: (Mortuary Technician) (Forensic Quality Specialist) 13247 Schubert, Stephen (Funeral Director) (License No.) EFTA00130108 FUNERAL DIRECTORS STATEMENT OF Avon:May Ti,,, matemem rs mute kr the P

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

the decedent that I have been authorized to remove. Released By: Released To: Demon, Sneyder (Monitory Technician) Verified by: NI udd, Joel (Forensic Quality Specialist) Schubert, Stephen (Funeral INrector) (License No.) EFTA00063555 RAOUL DIRECTOR'S STATIMENT OF AUTHORITY Ten lini (nal it reads 1w tae purpose

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

they correspond with the decedent that I have been authorized to remove. Released By: Released To: (Mortuary Technician) Verified by: Mu , oe (Forensic Quality Specialist) 13247 Schubert, Stephen (Funeral Director) (License No.) EFTA00133129 " • EFTA00133130 FUNERAL DIRECTOR'S STATEMury OF AUTHORITY Inn sta