Epstein Secrets

d Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: MLP Location: Drug Mfg: Lot Number: Dosage: Routo: Exp Dt: Comments: Smallpox Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: MLP Location: Drug Mfg: Lot Number: Dosage: Rou

Unit: 76318-054 NYM Z05 Screening encounter at Dental Clinic. Reason Not Done: Unavailable Comments: Patient has had several call outs for his Dental A & 0 screening but has not been escorted to Cosign Required: No Completed by Dental Asst on 07/19/2019 13:49. e dental clinic. Generated 07/19/201913

Date: 07/09/201912:51 EST Immunization Date: Provide (b)(Sl: (bl<7)(Cl Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: LP Smallpox Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: b><5> (b;(7xcJ MLP Location: Drug Mfg: Lot Number

ITE Provider: r b)(6); (b){?)(C) I Dental Asst Reg#: Facility: Unit: 76318-054 NYM 205 Comments: Patient has had several call outs for his Dental A & 0 screening but has not been escorted to the dental clinic. Cosign Required: No Completed b~""(b.,.,, >(5,.,... >: .,,.., (b>""' (7,..,.,)(c,.,...)--

ate: 07/09/2019 12:51 EST Immunization Date: Provider :b>C5>: (bKncc> MLP Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Smallpox Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: (b)<6>: (b)(ntc > MLP Location: Drug Mfg: Lot Num

WHITE Provider: r b)(G); (b)(7)(C) p ental Asst Reg#: Facility: Unit: 76318-054 NYM Z05 Comments: Patient has had several call outs for his Dental A & 0 screening but has not been escorted to the dental clinic. Cosign Required: No Completed b~~bl_r5_u _b)C-7J_cc_> --~ !Dental Asst on 07/19/2019 13:4

Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Smallpox Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: fb)(6); (b)(7)(C)IMLP Location: Drug Mfg: Lot Numb

WHITE Provider: rb)(6); (b)(7)(C) I Dental Asst Reg#: Facility: Unit: 76318-054 NYM Z05 Comments: Patient has had several call outs for his Dental A & 0 screening but has not been escorted to the dental clinic. Cosign Required: No Completed by~~b~)(6~);=(b~)(7=)(~C)-~IDental Asst on 07/19/2019 13:49

d Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: MLP Location: Drug Mfg: Lot Number: Dosage: Routo: Exp Dt: Comments: Smallpox Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: MLP Location: Drug Mfg: Lot Number: Dosage: Rou

nita Dental Asst Unit Z05 Screening encounter at Dental Clinic. Reason Not Done: Unavailable Comments: Patient has had several call outs for his Dental A & 0 screening but has not been escorted to dental clinic. Cosign Required: No Completed by DeBruce, Juanita Dental Asst on 07/19/2019 13:49. Generate

stered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Routo: Exp Dt: Comments: Smallpox Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Route:

Unit: 76318-054 NYM Z05 Screening encounter at Dental Clinic. Reason Not Done: Unavailable Comments: Patient has had several call outs for his Dental A & 0 screening but has not been escorted to Cosign Required: No Completed by n 07/19/2019 13:49. e dental clinic. Generated 07/19/201913:49 by Burea

stered Documented Date: 07/09/2019 12:51 EST Immunization Dato: Provider: Location: Drug Mfg: Lot Number: Dosage: Routo: Exp Dt: Comments: Smallpox Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Route:

Unit: 76318-054 NYM ZO5 Screening encounter at Dental Clinic. Reason Not Done: Unavailable Comments: Patient has had several call outs for his Dental A & 0 screening but has not been escorted to the dental clinic. Cosign Required: No Completed by Dental Asst on 07/19/2019 13:49. Generated 07/19/20191