CODE: FACILITY: NYM OPER CATG ASSIGNMENT OPER CATG ASSIGNMENT OPER CATG ASSIGNMENT NUM ASSIGNM OCT DATE QTR WRK 0001 HOSP 08-12-2019 EOS-539L SUICIDE OR TJNASSG 0002 08 - 12-2019 El2-592U FS PM SUICIDE OR GOOOO TRANSACTION SUCCESSFULLY COMPLETED Page 2867 Unit: Count: Metropol

0002 GOOOO ASSIGNMENT REG NO NAME HOSP f~b)~16F- 1·(~bX~7~C~) :....__=:-=.------~ TRANSACTION SUCCESSFULLY COMPLETED OCT DATE QTR 08-11-2019 EOS-539L 08-11-2019 El2-592U WRK SUICIDE OR UNASSG FS PM SUICIDE OR Page 2962 Signature: Print Name: Signature Signature: Print Name: Signature