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equipment ,other. Exp. Date: AYTPREirgEffirelartlitrriTittailiiiTtiziailiiiiciliiitiU ; • Equipment Start Date End Date C-Pap 07/30/2019 PHILIPS RESPIRONICS SYSTEM ONE CPAP MACHINE. SERIAL tt: P113121313B1ED. WO 110 • Wir .r. s'ziff : :Xie<; . :fr ; • Cleared for Food Service: Yes X No Restrict
llowing my expressed wishes and directions. ESGUERRA, S. X-RAY 7-10-2019 Counseled by Date cir bicSit.:- -7- to - Signature of Witness Date Patien Sign Lure Date NYM-NEW YORK MCC EFTA00049332 BP-A0818 JUN 18 U.S. DEPARTMENT OF JUSTICE A&O DENTAL EXAMINATION plait Clinigal Dental Findin
_basketball _handball stationary equipment • falergiffinagra urS areigiga nieig (Mif; •';' Equipment Start Date End Date Pap 07/30/2019 PHILIPS RESPIRONICS SYSTEM ONE CPAP MACHINE. SERIAL #: P11312813B1ED. Cleared for Food Service: Yes X No Restrictions Comments: N/A Health Services Staff • Exp. D
es from any and all liability for respecting and following my expressed wishes and directions. Counseled by Signature of Witness 7-10-2019 Date Patien Date NYM-NEW YORK MCC EFTA00105080 BP.S358.060 MEDICAL TREATMENT REFUSAL SEP 05 U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF RISONS 7-24-20
ther: _football _basketball _handball stationary equipment • faletanagra urS areigiga niiiiig •';' Equipment Start Date C-Pap 07/30/2019 PHILIPS RESPIRONICS SYSTEM ONE CPAP MACHINE. SERIAL #: P11312813B1ED. W m tali Cleared for Food Service: Yes X No Restrictions Comments: N/A ttiatts:niart Health
ts employees from any and all liability for respecting and following my expressed wishes and directions. RAY 7-10-2019 r\ t Counseled by Date Patien Signature Date Signature of Witness Date NYM—NEW YORK MCC ONY_00001026 EFTA_00000235 EFTA00134770 •• ••. •••••••• •••mm. BP-A0618 A&O D
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