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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
6318-054 Date of Bldh: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/28/2019 06:51 Provider: SRN Unit: H01 Date Initiated Esimat Handout/Tonic Copay Required: No Cosign Required: Yes TelophoneNerbal Order: No Completed by RN on 07/28/2019 07:22 Requested to be cosigned b
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
h: 01/20/1953 Encounter Date: 07/28/2019 06:51 Sex: Provider: M Race: WHITE ME RN Reg #: 76318-054 Facility: NYM Unit: H01 Date Initiated Esimat Handout/Tonic Copay Required: No Cosign Required: Yes TelophoneNerbal Orden No Completed by RN on 07/28/2019 07:22 Requested to be cosigned by
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
: 76318-054 Date of Bldh: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/28/2019 06:51 Provider: Unit: H01 Date Initiated Esimat Handout/Tonic Copay Required: No Cosign Required: Yes TelophoneNerbal Order: No Completed by on 07/2812019 07:22 Requested to be cosigned by
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