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Page 2427 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/28/2019 06:51 Provider: [P\ (17) Unit: HO1 Date Initiated Format Handout/Topic Provider Qutcome Copay Required: No Cosign Required: Yes Telephone/Verbal Order: No Completed by’ RN on 07/28/2019 07:22 Requested to be cosigned by/?° 8" Cosign documentation will be displayed on the following page. Generated 07/28/2019 07:22 by)0'O" 27" Bureau of Prisons - NYM Page 3 of 3 DOJ-OGR-00026103