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Page 2604 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 byo"®) Hire) MD 76318-054 Reg# Bureau of Prisons - NYM 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 Health Service Staff 07/30/2019 Date Page 1 of 1 DOJ-OGR- 00026264