Documents tagged "Phone Number"

Found 5 documents with this tag

DOJ-OGR-00006583.jpg

The image shows a printed document with text on it. The top part of the text is partially obscured, but what can be seen includes phrases such as "Request for" and "Laboratory Services" along with a file date in blue text that reads "08-26-97." Below this header, there are lines where information should be filled out, including sections titled "Patient Name," "Address," and "Phone Number." The document appears to be related to medical or healthcare services due to the context of its purpose. The style of the image is a simple photograph capturing the printed page without any additional embellishments or decorations.

Laboratory Services Patient Name Phone Number Request Laboratory Services Below Patient Name Address Phone Number

DOJ-OGR-00026332.jpg

The image displays a document with multiple columns of text information on a white background. The document appears to be a form or report with headings and various fields filled out. There is visible text including words such as "Date," "Name," "Address," "Phone Number," "Email Address," and sections labeled "Patient Information," "Medical History," and others that are not fully legible due to the resolution of the image. The document seems to be a medical or healthcare-related form, given the context of patient information typically requested in such documents.

Phone Number Email Address Patient Information Medical History Date Name Address Phone Number Email Patient Information Medical History

DOJ-OGR-00026287.jpg

The image shows a printed form with various fields and headings. At the top of the form is the title "Prisoners Health Services" followed by what appears to be an identification number in pink ink. There are sections titled "Patient Name," which is currently blank, "Medical Number," again left empty, and other areas such as "Date of Birth," "Address," and "Phone Number." Each section seems to be intended for specific personal information about the individual receiving healthcare services. The form has a structured layout with lines dividing different fields, suggesting it's designed to collect essential demographic and contact details.

Prisoners Health Services Patient Name Medical Number Phone Number Prisoners Health Services Patient Name Medical Number Date Birth Address Phone

DOJ-OGR-00026117.jpg

The image is a scanned document with a grainy quality due to the photocopying process. It appears to be a form or list of some kind with multiple columns and rows containing typed information. The text within the document includes phrases such as "Name", "Address", "Phone Number", "Email Address", and other fields that are typically found on identification cards, registration forms, or similar documents. There is also a date mentioned in the upper right corner of the form. It's not clear what the purpose of this document is from this description alone.

Phone Number Email Address Name Address Phone Number Email

DOJ-OGR-00022353.jpg

The image is a photograph of a printed document that has been altered to obscure personal information. The document appears to be a form with various fields such as "Name," "Address," and "Phone Number," but these sections are covered by black rectangles, preventing the legibility of any data within them. There's also text indicating some kind of contact information at the top of the page, though specific details are obscured for privacy reasons. The style of the image suggests it may be a government form or an official record requiring redaction to protect sensitive personal data.

Phone Number Name Address Phone Number