Epstein Secrets

EAST RIVE R MEDICAL IMAGING, PC Date: 10/14/2015 Patient Name: EPSTEIN, JEFFREY PATIENT INFORMATION RECORD Medical Record Number #: 0315192 Social Security it: 090.44-3348 Address: Apt/Unit/Suite: City. SAINT THOMA

EAST RIVE R MEDICAL IMAGING, PC Date: 10/14/2015 Patient Name: EPSTEIN, JEFFREY PATIENT INFORMATION RECORD Medical Record Number #: 0315192 Social Security it: 090.44-3348 Address: Apt/Unit/Suite: City. SAINT THOMAS State:

res or Defibrillator if yes, make\ year Ear Implants or Hearing Aids Electrical Stimulators Implant/Prosthesis Infusion Pumps Coils. Catheters, Filters or Wires in blood • Artifical Limbs or Joint Replacement Tattooed Eyeliner Artificial Heart Valves Stents If yes, please provide date of implant: Magnet

EAST RIVER MEDICAL IMAGING. PC MAGNETIC RESONANCE IMAGING IMRI) Patient Name; EPSTEIN. JEFFREY MRN #: 0315192 Age: 65 Years Sex: M Height Feet Inches Weight Referring Physician: MOSKOVVITZ, BRUCE W. M.D. M.D. Exam Code: MRCL

RESONANCE IMAGING IMRI) Patient Name; EPSTEIN. JEFFREY MRN #: 0315192 Age: 65 Years Sex: M Height

fragment or foreign body O Ear Implants or Hearing Aids O Electrical Stimulators O Implant/Prosthesis O Infusion Pumps 0 Coils. Catheters. Filters or Wires in blood O Artifical Limbs or Joint Replacement O Tattooed Eyeliner O Artificial Heart Valves O Stents If yes, please provide date of implant

EAST RIVER MEDICAL IMAGING. PC Date: 06/05/2018 Patient Name: EPSTEIN, JEFFREY PATIENT INFORMATION RECORQ Medical Record Number #: 0315192 Social Security Address: 6100 RED HOOK QUARTERS Apt/Unit/Suite: APT B3 C

EAST RIVER MEDICAL IMAGING. PC Date: 06/05/2018 Patient Name: EPSTEIN, JEFFREY PATIENT INFORMATION RECORQ Medical Record Number #: 0315192 Social Security Address: 6100 RED HOOK QUARTERS Apt/Unit/Suite: APT B3 City: SAIN

n body CI O Ear Implants or Hearing Aids 0 C7 Electrical Stimulators 0 0 Implant/Prosthesis CI 0 Infusion Pumps 0 0 Coils. Catheters. Filters or Wires in blood 0 0 Artifical Limbs or Joint Replacement CI 0 Tattooed Eyeliner 0 O Artificial Heart Valves 0 0 Stents If yes, please provide d