Epstein Secrets

soner refuses to sign, note that in the signature block. All refusals should be immediately reported to the Otftce of Interagency Medical Services. Prisoner Services Division. The completed USM form 552 is to be retained in the prisoner's files, Section I - USMS Prisoner Information I. nisoner Name (Last. First. MO 2 US

Fre e 103 t? 3. CY riet Name / 4 Diann it SPA T Ocr 7 5 Cu,' gy ts o Section I! - Prisoner Personal Data And Medlesi Information 6. Dale Of Birth lMolbaylYr) r 0 -- S -2 S. Medical Insurance Information Ay buitrawc comgany Same , ofo th.t.#1714 Section III - Medical Consent And Records

soner refuses to sign, note that in the signature block. All refusals should be immediately reported to the Office of Interagency Medical Services. Prisoner Services Division. The completed USM loan 552 is to be retained in the prisoner's files. Section I - USMS Prisoner Information 1. Prisoner Name (Last. First MI) 2.

USMS Prisoner E i ge.cr ea rid/ ,Je Erni/ 3. Di (rid Name / 4. District , 40/1 Section II - Prisoner Personal Data And Medical Information 6. Dale Of Birth (Mornay/Yr) 8. Medical Insurance Infomution A) Insurance Qompany Name eA r eed - Mkt / 4 CAR.- 13) licy 111 thee, es Po ID5 /? -37 Medic cime

soner refuses to sign, note that in the signature block. Al! refusals should he immediately reported to the Office of Interagency Medical Services. Prisoner Services Division. The completed USM form 552 is to be retained in the prisoner's files. Section I - USMS Prisoner Information I. Prisoner Name (Last. Fite. 5714/

e (Last. Fite. 5714/ NJerrre 3. Oi3triet Name r f I4 District [2.USMS Prisoner Section It - Prisoner Personal Data And Medics! Information 6. Dale Of Birth IMo/DayrYr) 8. Medical Insurance Information A) Instira9ce comciany Name i U/Ofeid- , he -ALL ot si„ ry So. H .— 2211? 13g ) Policy tinstler