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Bureau of Prisons Health Services Modified Diet Request Types of Diets: ____ Clear Liquid ____ Low Fat ___ Mechanical Soft ____ Low Cholesterol ____ Low Triglyceride ___ Renal ___ Full Liquid ___ Sodium Controlled ____ Snack ____ Diabetic ___ Calorie Controlled _X Other: — FISH ALLERGIES. Comments: EPSTEIN, JEFFREY EDWARD Inmate Name Generated 07/30/2019 14:57 by (bey, BANC) ] MD Exp Date: Exp Date: Exp Date: Exp Date: Exp Date: Exp Date: Exp Date: Exp Date: Exp Date: Exp Date: Exp Date: Exp Date: 07/30/2020 (xe. IMD Health Service Staff 76318-0054 07/30/2019 Reg# Date Bureau of Prisons - NYM Page 1 of 1 DOJ-OGR-00024155