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6318-054 Date of Bldh: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/28/2019 06:51 Provider: SRN Unit: H01 Date Initiated Esimat Handout/Tonic Copay Required: No Cosign Required: Yes TelophoneNerbal Order: No Completed by RN on 07/28/2019 07:22 Requested to be cosigned b
0 MG) twice daily by of water Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML Exp: 10/28/2019 SIG: shake well take 10mI by daily AS NEEDED Omega 3 (Vascepa) 1 GM Capsule Exp: 01/13/2020 SIG: Take two capsules (2 GM) twice daily by OTCs: Listing of all known OTCs this inmate is currently taking. None P
h: 01/20/1953 Encounter Date: 07/28/2019 06:51 Sex: Provider: M Race: WHITE ME RN Reg #: 76318-054 Facility: NYM Unit: H01 Date Initiated Esimat Handout/Tonic Copay Required: No Cosign Required: Yes TelophoneNerbal Orden No Completed by RN on 07/28/2019 07:22 Requested to be cosigned by
0 MG) twice daily by of water Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML Exp: 10/28/2019 SIG: shake well take 10mI by daily AS NEEDED Omega 3 (Vascepa) 1 GM Capsule Exp: 01/13/2020 SIG: Take two capsules (2 GM) twice daily by OTCs: Listing of all known OTCs this inmate is currently taking. None P
: 76318-054 Date of Bldh: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/28/2019 06:51 Provider: Unit: H01 Date Initiated Esimat Handout/Tonic Copay Required: No Cosign Required: Yes TelophoneNerbal Order: No Completed by on 07/2812019 07:22 Requested to be cosigned by
0 MG) twice daily by of water Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML Exp: 10/28/2019 SIG: shake well take 10mI by daily AS NEEDED Omega 3 (Vascepa) 1 GM Capsule Exp: 01/13/2020 SIG: Take two capsules (2 GM) twice daily by OTCs: Listing of all known OTCs this inmate is currently taking. None P
76318-054 Date of Bit 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/28/2019 06:51 Provider: SRN Unit: H01 Date Initiated Esimat Handout/Tonic Copay Required: No Cosign Required: Yes TelephoneNerbal Order: No Completed by RN on 07/28/2019 07:22 Requested to be cosigned b
0 MG) twice daily by of water Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML Exp: 10/28/2019 SIG: shake well take 10ml by daily AS NEEDED Omega 3 (Vascepa) 1 GM Capsule Exp: 01/13/2020 SIG: Take two capsules (2 GM) twice daily by OTCs: Listing of all known OTCs this inmate is currently taking. None P
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