IN, JEFFREY EDWARD Reg #: 76318- J54 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/26/2019 07:54 Provider. Ancrum, Cheryl DOS Unit: H01 ASSESSMENTS: Health Problems as of Dental Health History Encounter date: 07/26/2019 07:54 Health Problems litmalalatam S

EIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/26/2019 07:54 Provider: Ancrum. Cheryl DDS Unit: H01 ASSESSMENTS: Health Problems as of Dental Health History Encounter date: 07/26/2019 07:54 Health Problems Health Problem

EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Encounter Date: 07/26/2019 07:54 Reg #: 76318-054 Sex: M Race: WHITE Facility: NYM Provider: Ancrum, Cheryl DDS Unit: H01 ASSESSMENTS: Health Problems as of Dental Health History Encounter date: 07/26/2019 07:54 Health Problems Health Problem

EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Encounter Date: 07/26/2019 07:54 Reg #: 76318-054 Sex: M Race: WHITE Facility: NYM Provider: Ancrum, Cheryl DDS Unit: H01 ASSESSMENTS: Health Problems as of Dental Health History Encounter date: 07/26/2019 07:54 Health Problems Health Problem