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Page 508 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 08/10/2019 07:25 Provider: [5x6 mirc Unit: Z04 Exam: ASSESSMENT: Cardiac Arrest PLAN: New Consultation Requests: Consultation/Procedure Target Date Scheduled Target Date Priority Translator Lanquage Emergency Room 08/10/2019 08/10/2019 Emergent No Subtype: AMBULANCE Reason for Request: Cardiac arrest with CPR in progress Copay Required: No Cosign Required: Yes Telephone/Verbal Order: No on 08/10/2019 08:10 6): (DMT HC) D. Cosign documentation will be displayed on the following page. Generated 08/10/2019 08:10 by’ Bureau of Prisons - NYM Page 2 of 2 DOJ-OGR-00024965