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Cosign Note - Intake Cosign encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider. MED CL:1 NO CCC APPT. Discontinued Laboratory Requests: Details Frequency Lab Tests-H-Hemoglobin AlC One Time Lab Tests-C-CBC w/diff Lab Tests-L-Lipld Profile Lab Tests-C-Comprehensive Met
g /!: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/10/2019 16:58 Provider. Lab Result Receive Facility: NYM CosIgnod bye MD on 07/14/2019 18:12. &IMAM of Prisons • NYM EFTA00059496 BP-S358.060 MEDICAL TREATMENT REFUSAL CDFRM SEP C6 U.S. DEPARTMENT OF JUSTIC
Cosign Note - Intake Cosign encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider. MED CL:1 NO CCC APPT. Discontinued Laboratory Requests: Details Frequency Lab Tests-H-Hemoglobin AlC One Time Lab Tests-C-CBC w/diff Lab Tests-L-Lipld Profile Lab Tests-C-Comprehensive Met
g /!: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/10/2019 16:58 Provider. Lab Result Receive Facility: NYM CosIgnod bye MD on 07/14/2019 18:12. &IMAM of Prisons • NYM EFTA00132659 BP-S358.060 MEDICAL TREATMENT REFUSAL CDFRM SEP CS U.S. DEPARTMENT OF JUSTIC
n Note - Intake Cosign encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider. =MM. MED CL:1 NO CCC APPT. Discontinued Laboratory Requests: Details Frequency Lab Tests-H-Hemoglobin AlC One Time Lab Testsi-CBC w/diff Lab Tests-L-Lipld Profile Lab Tests,Comprehensive Metabo
g /!: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/10/2019 16:58 Provider. Lab Result Receive Facility: NYM CosIgnod by on 07/14/2019 18:12. Bureau of Prisons • NYM EFTA00105055 BP-S358.060 MEDICAL TREATMENT REFUSAL CDFRM SEP CS U.S. DEPARTMENT OF JUSTICE
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