Document Mentions (4 shared documents)

EFTA00110421

2 mentions1 same-page

Page ?Same page

s from examination date) BWs: Pancras: Patient Name:k I C O 3 — cich E. Dentist Si nature: 1:47S FictsfNuter 76 3 ISE- 051/41 Institution: MCC NEW YORK Date: 7- 26 -I 9. Signature Block/Stamp: DDS. PDF Prescribed by P64C* let Uental cer MCC New York Replaces BP-A0618 of JUN 10 EFTA00110437

er: Dental Ant Unit: ZOS Screening encounter at Dental Clinic. Reason Not Done: Unavailable Comments: Patient has had several call outs for his Dental A & O screening but has not been escorted to the dental clinic. Cosign Required: No Completed by Dental Asst on 07/19/2019 13:49. Generated 07/19120191

EFTA00140222

2 mentions1 same-page

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ths from examination date) BWs: Panonax: Ream Name:k o i c 3— cp.e. S Dentist ' • t>17_5' Ffti-st : fm?nbe, 76 3 ISE- 051/41 Institution: MCC NEW YORK Date: 7- 2.6 -/ 9. Signature BlockAtamp: DDS. PDF Prescribed by P64C* er Uentaiumcer MCC New York Replaces BP-A0618 of JUN 10 EFTA00140238

EFTA00044963_email_034_sub_002 - EFTA00044963_705

2 mentions1 same-page

Page ?Same page

Ws: Panorer. Pagan Name:, S -1-C4 -3 —Cc-PR.-ti E n Dentist Signature: 0 - L1-44014LAA.4— >DS st r Number. f -7(, 31Se- USN Institution: / MCC NEW YORK Date: 7- z6. ---/ 9. Signature Block/Stamp: C. Ancrum DDS. PDF Prescribed by P6400 let L)ental Umcer MCC New York Replaces BP-A0618 of JUN 10

ita Dental Asst Unit: Z05 Screening encounter at Dental Clinic. Reason Not Done: Unavailable Comments: Patient has had several call outs for his Dental A & O screening but has not been escorted to the dental clinic. Cosign Required: No Completed by DeBruce, Juanita Dental Asst on 07/19/2019 13:49. Gener