Epstein Secrets

lid 18 months from examinalion date) SW5: Panorex Pa t Name:, sh n, D —Ccici -Jty E Dentst : -1 7 ‘ 3 Isre Nutt.: I US-`} institution:/ MCC NEW YORK Date: 7- 24 9. Signature Block/Stamp: DDta PDF Ghlet uental r MCC New York Presorted by P640) Replaces SP-A0(IIS 01JUN 10 EFTA00059498 Bure

Referred to Sick Call: Radiographs authorized: PAs• . Prophylaxis auUtortzect Yes I No (Approval var 18 months from examination date) EPNs: Panorox iPc t Nan= i 9 4t, n -376 1-rite_ E. Dentist Si nature: 1,3" it 7‘ lisznben 3 IS= OS-1/4\ Institution: MCC NEW YORK Date: 7- 06 -1 9. Si

om examination date) I BY& Panorex Pap nt s Name: s-QO . 1 —3--e_c-R•fe_y E Den I I ...: 47Etergurnber: -7 4,3is: OS-1/41 Institution: / MCC NEW YORK Date: 7- zo. -I 9. B Stamp: PDF Prescribed by P6403 e7 Dental cer MCC New York Replaces BP-A0B18 of JUN 10 EFTA00105082 BP4,0618 JUN 18 U

nt Retuned to Sick Call: Radiographs authorized: FAa- . Prophylaxis augtortzect Yes I No (Approval var 18 months from examination date) EPNs: Panorox iPc t Nemec i 9 Skin teS ti E Den' ! Nu isitsr _7‘ tsts.mben 3 I Sr- OSN Institution:/ / MCC NEW YORK Date: 7- 26 -1 9. Signature Block/St

months from examinant, date) SW5: Patton= Pa t Name: , skin , -376--chy s 0 • • el 9. RDS 7(:, Nunber: I 3 I Sr- OS-L3/4 institution: / MCC NEW YORK Date: 7- 2 O Signature Block/Stamp: -DDS. PDF l:hlel Uental r MCC New York • Presorted by P84O) RcVaces BRAopte olJUN 10 SDNY_II0000993 I E

nt Referred to Sick Colt Radiographs authorized: PM. . Prophylaxis authorizect Yes I No (Approval var 18 months from examination date) BW5: Panorox :ga t Narrar. , 9 SA.C.4 O -5;SV7 -42_ti 2- D ' I alur : 1)17-5 istur Number: i I \ Institution: / MCC NEW YORK Date: 7 .- 74 -19. /Stamp