Varicella Series Administration: History Unknown
ORGANIZATIONWork Restriction / Limitation
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54 Fealty: NYM Unit: 1101 Immunization Date: Provider: Joaquin, Y. MLP 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: Joaquin, Y. MLP Location: Drug Mfg: Lot Number: Dosage:
ssession: Equipment Start Date End Date Return Date C-Pap 07/30/2019 PHILIPS RESPIRONICS SYSTEM ONE CPAP MACHINE. SERIAL #: P11312813B1ED. Work Restriction / Limitation: Cleared for Food Service: Yes X No Restrictions Comments: N/A Beaudouin, Robert MD 07/30/2019 Health Services Staff Date Inmate Name: EPST
4 Facility: NYM Unit: H01 Immunization Date: Provider: Joaquin, Y. MLP 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: Joaquin, Y. MLP Location: Drug Mfg: Lot Number: Dosage:
jogging _walking _softball _football _basketball _handball _stationary equipment other: May have the following equipment in his / her possession: Work Restriction / Limitation: Cleared for Food Service: Yes X No Restrictions Comments: N/A Health Services Staff Joaquin, Y. MLP Inmate Name: EPSTEIN, JEFFREY EDWARD ALL
4 Facility: NYM Unit: H01 Immunization Date: Provider: Joaquin, Y. MLP 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: Joaquin, Y. MLP Location: Drug Mfg: Lot Number: Dosage:
jogging _walking _softball _football _basketball _handball _stationary equipment other: May have the following equipment in his / her possession: Work Restriction / Limitation: Cleared for Food Service: Yes X No Restrictions Comments: N/A Health Services Staff Joaquin, Y. MLP Inmate Name: EPSTEIN, JEFFREY EDWARD ALL
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: Dosage: Route: Exp Dt:
Exp. Date: _football _basketball _handball _stationary equipment — other: Exp. Date: May have the following equipment in his / her possession: Work Restriction / Limitation: Cleared for Food Service: Yes X No Restrictions Comments: N/A 07/09/2019 Health Services Staff Date Inmate Name: EPSTEIN, JEFFREY EDWARD R
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:
nt Start C ite End Date Return Date C-Pap 07 ni 19 PHILIPS RESPIRONICS SYSTEM ONE CPAP MACHINE. SERIAL #: P11312813B1ED. Page 082 of 148 Work Restriction / Limitation: Cleared for Food Service: Yes X No Restrictions Comments: N/A Withheld pursuant to exemption (b)(6) (b)(7)(A) (b)(7)(C) of the Freedom of Info
b)(6); (b)(7)(C) IMLP Immunization Date: Provider: b)(G); <b>(7 lCC> LP 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 (b)(G): (b)(7)CC> MLP Location: Drug Mfg: Lot Number: Dos
Exp. Date: ------ football basketball stationary equipment other: Exp.Da~: _____ _ May have the following ectuipinent in his/ her possession: Work Restriction / Limitation: Cleared for Food Service: Yes ---- x No Restrictions Comments: N/A f b:(6); (b)(7)(C) IMLP 07/09/2019 Health Services Staff Date Inmate Na
b)(6); (b){7){C) MLP Immunization Date: Provider: (bl<5>; <bJ(7J<c ) MLP 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: (b)(6); (b)(7)(C) Provider .__ ___ ..... MLP Location: Drug Mfg: L
session: Equipment Start D.:\te End Date Return Date C-Pap 07/30i2019 PHILIPS RESPIRONICS SYSTEM ONE CPAP MACHINE. SERIAL#: P1 1312813B1 ED. Work Restriction / Limitation: Cleared for Food Service: Yes --- x No Restrictions Comments: N/A r )(6); (b)[7)(C) 07/30/2019 Health Services Staff Date Inmate Name: __ E_
. Unit: Immunization Date: Provider: ~ )(6); IMLP -~- VZ~V-C-' _ _._ 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: V,X6), b\Q\IC\ IMLP Location: Drug Mfg: Lot Number: Dos
possession: Equipment Start Date End Date Return Date C-Pap 07/30/2019 PHILIPS RESPIRONICS SYSTEM ONE CPAP MACHINE. SERIAL#: P11312813B1ED. Work Restriction / Limitation: Cleared for Food Service: Yes --- x No Restrictions Comments: N/A Health Services Staff rb)(6); (b)(7)(C) 07/30/2019 Date Inmate Name: __ E_
9/2019 12:35 Provider: MLP Unit: H01 Immunization Date: Provider: MLP 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: MLP Location: Drug Mfg: Lot Number: Dosage: Route: Exp
equipment in his / her possession: Equipment Start Date C-Pap 07/30,2019 PHILIPS RESPIRONICS SYSTEM ONE CPAP MACHINE. SERIAL #: P11312813B1ED. Work Restriction / Limitation: Cleared for Food Service: Yes X No Restrictions Comments: N/A Beaudouin, Robert MD Health Services Staff Date End Date Return Date 07/30/20
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