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Pap Travel: Direct Travel: No Travel Restrictions: None UNIVERSAL PRECAUTIONS OBSERVED WHEN TRANSPORTING ANY INMATE: Transfer From Institution: NEW YORK MCC Phone Number: 6468366300 Address 1: 150 PARK ROW Address 2: City/State/Zip: NEW YORK, New York 10007 Name/Title of Person Completing Form: RN
ls TB Clearance: Yes Last PPD Date: 07/09/2019 Induration: 0mm Last Chest X-Ray Date: TB Treatment: TB Follow-up Recommended: No Sickle Cell: Sickle Cell Trait/Disease: No Results: Sx free for 30 days: Yes Generated 08110/2019 07:00 by CONFIDENTIAL RN Bureau of Prisons - NYM Page 1 of 2 SDNY_00009442 EFTA
-Pap Travel: Direct Travel: No Travel Restrictions: None UNIVERSAL PRECAUTIONS OBSERVED WHEN TRANSPORTING ANY INMATE: Transfer From Institution: NEW YORK MCC Phone Number: 6468366300 Address 1: 150 PARK ROW Address 2: City/State/Zip: NEW YORK, New York 10007 Name/Tale of Person Completing Form: Col
D Date: 07/09/2019 Qua= Details 66 y/() male 3 different stools Last Chest X-Ray Date: TB Treatment TB Follow-up Recommended: No Sickle Cell: Sickle Cell Trait/Disease: No Provider Optometrist Mid-Level Provider Physician 01 Nurse Induration: 0mm Results: Sx free for 30 days: Yes Generated 08/10/2019 O7:0O
Pap Travel: Direct Travel: No Travel Restrictions: None UNIVERSAL PRECAUTIONS OBSERVED WHEN TRANSPORTING ANY INMATE: Transfer From Institution: NEW YORK MCC Phone Number. 6468366300 Address 1: 150 PARK ROW Address 2: City/State/Zip: NEW YORK, New York 10007 Namerfltle of Person Completing Form:
/06/2019 One Time TB Clearance: Yes Last PPD Date: 07/09/2019 Last Chest X-Ray Date: TB Treatment TB Follow-up Recommended: No Sickle Cell: Sickle Cell Trait/Disease: No Dualism Retails 66 y/o male 3 different stools Induration: 0mm Results: Sx free for 30 days: Yes Generated 08/10/2019 07:00 by RN Bure
Pap Travel: Direct Travel: No Travel Restrictions: None UNIVERSAL PRECAUTIONS OBSERVED WHEN TRANSPORTING ANY INMATE: Transfer From Institution: NEW YORK MCC Phone Number. 6468366300 Address 1: 150 PARK ROW Address 2: City/State/Zip: NEW YORK, New York 10007 Namerfitle of Person Completing Form:
/06/2019 One Time TB Clearance: Yes Last PPD Date: 07/09/2019 Last Chest X-Ray Date: TB Treatment TB Follow-up Recommended: No Sickle Cell: Sickle Cell Trait/Disease: No Dualism Retails 66 y/o male 3 different stools Induration: 0mm Results: Sx free for 30 days: Yes Generated 08/10/2019 07:00 by Bureau o
Pap Travel: Direct Travel: No Travel Restrictions: None UNIVERSAL PRECAUTIONS OBSERVED WHEN TRANSPORTING ANY INMATE: Transfer From Institution: NEW YORK MCC Phone Number. 6468366300 Address 1: 150 PARK ROW Address 2: City/State/Zip: NEW YORK, New York 10007 Namerfltle of Person Completing Form:
/06/2019 One Time TB Clearance: Yes Last PPD Date: 07/09/2019 Last Chest X-Ray Date: TB Treatment TB Follow-up Recommended: No Sickle Cell: Sickle Cell Trait/Disease: No Duration Petah 66 y/o male 3 different stools Induration: 0mm Results: Sx free for 30 days: Yes Generated 08/1 0/2019 07:00 by RN Burea
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