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mily History - Sibling: Number of Siblings: 1 Significant Illnesses: Comments: Past Hospitalization: Reason Location When Acute Appendicitis Mount Sinai Hospital 1990 Complications: None Comments: Head: Normal: Yes Comments: Generated 0710912019 13:03 by MLP Bureau of Prisons - NYM Page 7 of 13 EFTA
07/10/2019 14:46 LIS ID 188191004 HIV HIV 1/2 Negative Screening test - See confirmatory testing for Reactive results Negative FLAG LEGEND L=Low LI=Low Critical H=I-ligh H!=High Critical A=Abnormal A! =Abnormal Critical Page 3 of 3 EFTA00121393 Bureau of Prisons Health Services Cosign/Revie
ts: Family History - Sibling: Number of Siblings: 1 Significant Illnesses: Comments: Past Hospitalization: Reason Location Acute Appendicitis Mount Sinai Hospital Complications: None Comments: Head: Normal: Yes Comments: When 1990 Generated 07/0912019 13:03 by MLP Bureau of Prisons NYM Pale 7 of 13
6.3 <5.7 SEROLOGY RPR Non-Reactive Results may be affected In patients with severely advanced Immunosuppression. Non-Reactive FLAG LEGEND L=Low LI=Low Critical li=High HI=High Critical A=Abnorrnal Al =Abnormal Critical Page 2 of 3 EFTA00050837 @ Federal Bureau of Prisons Name EPSTEIN, JEF
mily History - Sibling: Number of Siblings: 1 Significant illnesses: Comments: Past Hospitalization: 'Mason Location When Acute Appendicitis Mount Sinai Hospital 1990 Complications: None Comments: Head: Normal: Yes Comments: Generated 07/09/2019 13:03 by Joaquin, Y. MLP Bureau of Prisons • NYM Page 7
.4 Diabetes SEROLOGY RPR Non-Reactive Non-Reactive Results may be affected in patients with severely advanced immunosuppression. FLAG LEGEND L=Low LI=Low Critical H=High HI=High Critical A=Abnormal Al =Abnormal Critical Page 2 of 3 EFTA00049724 C Federal Bureau of Prisons U.S. Medical Center
of Siblings: 1 Significant Illnesses: Comments: Past Hospitalization: on Speaking/Listening English None Reason Location Acute Appendicitis Mount Sinai Hospital Complications: None Comments: Head: Normal: Yes Comments: When 1990 Ger-waled 07/C9/2019 13.03 by MLP Bureau of Prisons • NYM Page 7 of 13
"3/uL <5.7 SEROLOGY RPR Non-Reactive Results may be affected in patients with severely advanced immunosuppression. Non-Reactive FLAG LEGEND L=Low LI=Low Critical H=High H!=High Critical A=Abnorrnal Al =Abnormal Critical Page 2 or' 3 EFTA00059494 Federal Bureau of Prisons U.S. Medical Cente
of Siblings: 1 Significant Illnesses: Comments: Past Hospitalization: on Speaking/Listening English None Reason Location Acute Appendicitis Mount Sinai Hospital Complications: None Comments: Head: Normal: Yes Comments: When 1990 Ger-waled 07/C9/2019 13.03 by MLP Bureau of Prisons • NYM Page 7 of 13
"3/uL <5.7 SEROLOGY RPR Non-Reactive Results may be affected in patients with severely advanced immunosuppression. Non-Reactive FLAG LEGEND L=Low LI=Low Critical H=High H!=High Critical A=Abnorrnal Al =Abnormal Critical Page 2 or' 3 EFTA00132657 Federal Bureau of Prisons U.S. Medical Cente
of Siblings: 1 Significant Illnesses: Comments: Past Hospitalization: on Speaking/Listening English None Reason Location Acute Appendicitis Mount Sinai Hospital Complications: None Comments: Head: Normal: Yes Comments: When 1990 Ger-waled 07/C9/2019 13.03 by Bureau of Prisons • NYM Page 7 of 13 EFT
"3/uL <5.7 SEROLOGY RPR Non-Reactive Results may be affected In patients with severely advanced immunosuppression. Non-Reactive FLAG LEGEND L=Low LI=Low Critical H=High H!=High Critical A=Abnorrnal Al =Abnormal Critical Page 2 or' 3 EFTA00105053 Federal Bureau of Prisons U.S. Medi I Prison
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