3
Shared Docs
3
Same-Page
3 / 3
Mentions
es below. K Referring Physician: MOSKOWITZ BRUCE W. M D. M.D. K Referring Physician's Address: 11 N
s If yes, please provide date of implant Magnetic Dental Implants Transdermal Patches IUD Tissue expander for future implants Bone Stimulators. Insulin Pumps, or Mechanical Valves Programmable Shunts WARNING: Before entering the MR room, you must remove all metallic objects Including HEARING AIDS, DENTU
Weight Referring Physician: MOSKOVVITZ, BRUCE W. M.D. M.D. Exam Code: MRCLAVL lbS Exam Date: 06/
e provide date of implant: O Magnetic Dental Implants O Transdermal Patches 0 IUD O Tissue expander for future implants O Bone Stimulators. Insulin Pumps. or Mechanical Valves O Programmable Shunts WARNING: fore entering the MR room, you must remove all metallic objects including HEARING AIDS, DEN
06/05/2018 Referring Physician: MOSKOWITZ. BRUCE W. M.D. M.D. Acc# 7156124 IMPORTANT: Please notify
implant: 0 Q Magnetic Dental Implants I= D Transdermal Patches CI D IUD 0 0 Tissue expander for future implants 0 0 Bone Stimulators. Insulin Pumps, or Mechanical Valves 0 D Programmable Shunts WARNING: Before entering the MR room, you must remove all metallic objects including HEARING AIDS,
Entities connected to both George W. Bush and Insulin Pumps

Jeffrey Epstein
PERSON
Bruce Moskowitz
PERSON
BRUCE W
PERSONK Visa
ORGANIZATIONPacer Wires or Defibrillator
ORGANIZATIONFilters or Wires
ORGANIZATIONMechanical Valves
ORGANIZATIONTHE TIME OF SERVICE
ORGANIZATIONSignature of Patient
ORGANIZATIONEast River Medical
ORGANIZATIONBRUCE W. M.D. M.D.
PERSONK Return
ORGANIZATION