Epstein Secrets

Reg #: 76318-054 Facility: NYM Unit: H01 Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Varicella Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Location: Drug Mfg: Lot Number: Page 055 of 148 Dosage:

90 day(s) SLIDING SCALE Subcutaneously - Two Times a Day x 7 day(s) Pill Line Only 008 of 148 Withheld e emption Details Frequency Due Date General Radiology-Spine / Cervical- One Ti(ix)(6); (b)( )(C) 08/29/2019 General Specific reason(s) for request (ttfififtSiffigraei6 InfRnalje 66 YR OLD MALE WITH COMPL

Provider. IMIll ekILP Unit: F01 Immunization Date: Provider: IMIE. MLP Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Varicella Series Administration: History Unknown, Not Administered Documented Date: 07/09/201912:51 EST Immunization Date: Provider: NEB MLP Location: Drug Mfg: Lot Number: Dosage: Route:

x 7 day(s) Pill Line Only prescriber Order Take the tablet by mouth as directed x 6 day(s) Due Date Priority. Frequency, Due Date Priority. General Radiology-Spine / Cervical- One Time 08/29/2019 Routine General Specific reason(s) for request (Complaints and findings): 66 YR OLD MALE WITH COMPLAITN OF RIGH

76318-054 HITS Facility: NYM Unit: F01 Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Varicella Series Administration: History Unknown, Not Administered Documented Date: 07/09/201912:51 EST Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt:

x 7 day(s) Pill Line Only prescriber Order Take the tablet by mouth as directed x 6 day(s) Due Date Priority. Frequency, Due Date Priority. General Radiology-Spine / Cervical- One Time 08/29/2019 Routine General Specific reason(s) for request (Complaints and findings): 66 YR OLD MALE WITH COMPLAITN OF RIGH