Documentos de Académico
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Exhibit Page 17
SENDER:-COMPEETE THIS SECTION
11 Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery ls desired.
!ii Print your name and address on the reverse
so that we can return the card to you.
11 Attach this card to the back ot the mailpiece,
or on the front if space permits.
1. Article Addressed to:
r"\ A;Sec.c"'- v-Sc fu '-
< "'--\ .._,_
,}._')CJ kJa.' k ..... s 1-e ,{ St '
So ITT"" I v'li\ r+ . a!) ( (J
0
2. Article Number
COMPLETE: THIS SECTION ON DELIVERY
D Agent
D Addressee
!f YES, enter delivery address below:
D Express Mail
3. Senrice Type
Mail
D Registered
D Insured Mail
D Return Receipt for Merchandise
0 C.O.D.
4. Restricted Delivery? (Extra Fee)
DYes
(f ransfer from seNice label) 7012 2920 DODD 8755 7544
PS Form 3811 , February 2004 Domestic Return Receipt
Exhibit Page 18
,JIU Griffin, MD
PedalMed.com
41 Locust Street, Northampton, MA 01060
413"588-6848
Massachusetts Department of Publlo Heal!h
250 Washington Street
Boston, MA 01208
To Whom H May Concern:
r would like lo apply enroll In t11e medical marijuana .
and logether, we have determined that I suf/er fro program. J have been evaluatEl\1 by Jill G rlffln MD
risks versus benefits of using medlcal deblflta\lng medJca/ condition. I have th
program. I realize that Dr. Grlflln oan't "prescribe" r Griffin and I am making a choice to enroll In tl1:
na1 uana, she may only "recommend" ii'
f ackno I d h s use.
we ge I e tlmltallons on my aulhorlzallon t
The Commonwealtt1 o/ Massachuseus. o possess and use marijuana for medical purposes in
I sites! by signing below that I will nol engage In the diversion ol '/ man uana.
I attest by s!gnlng below that I understand II
marijuana for niedlcal use are app!tcable cMllons conferred by lhe Act for possesslon of
1 n assachuseUs.
I a Ile st by signing below that the Stale or Massad1use!ts Js my primary state of residence
1 sltest by signing below that I under 1
dale of Issue
8
and that my registration Is vaUd for a perlod of 0,, y 1 e ear rom the
I aUeat by signing below ll1at I am J tJ - ----years of age.
Patient Last Name: fV) v.,r n;...----------
Pallent FJtsl Name: _}.Se
Dale of Birth: 'I ____ . ___ _
Ad'""' __bl.ill_
\.- c._.\.e _
Phone: t//3-ll..&'-S"b.3? Emall: _o/L,/mf;<r6rrJ (.) /,,.t -- ( ,
r .... ("){"
Pallent Signature: 1Jflft1.-
Date:
Ji11GrHfl11, MD
PetlalMed.com
41 Locust Street, Nrnlilamp\on, MA 01060
413.588.6848
Recommendation for the Huma11\larlao Medical Use of Marijuana In Massachuse\ls
Patient h1for111atlon:
Last Name:
Date of Blrt11. 3
Street:
First Name: ___fu.ci___._ _______ _
Phone: Lll?>-!a61{-i1.1"1
C\ty: \A) 0 \ <. > ----------- MA Zip: ....Q.1Jl\----
Physician lnfofmatlon:
Name:
Bus. Address:
Bus. Name:
MA Med Uc#:
MD DEA:
FED DEA:
Phone:
ernall:
Fax:
Jiii Griffin, MD
41 Locust St., Northampton, MA 01060
Maglc carpel Medical, LLC dba.Peda!Med.com
156085 exp
MG0481678A
BG5962445 nd XG5962445
413-588-6848
none
-----------------------PLEASE DO NOT WRITE BELOW THIS LINE------------------
1, Jlll Griffin, MD, am ttie cer\ifylng physician. I conducted a cllnlcal v\sll, compleled an assessment of mY pallent's
current medical condllion, h8'v'e explalned the potential rlsks versus bene1ils of marijuana wilh \Ile patient, and have
scheduled fo!!owup with my patient. In my professional oplnlon, the polent!al benefits of !he medk;al use of marijuana
lil(ely outweigh the risks for lhls patient.
Oeblllta!lng Medical Condltlora: -pel.'.n
SJgnsisvmptoms: -13",_I
! ..Q..OJ s?-Dl'.)
"Tills certlficatlon expires one year from the date It was signed
Exhibit Page 19
--- -- -------
TOWN OF STURBRIDGE
POLICE DEPARTMENT
Office of the Chief of Police
THOMAS J. FORD ill
346 Main Street, Sturbridge, MA 01566
Office (508) 347-2525 Fax (508) 347-7904
Sturbridgepd@charter.net ___ .. -
IMPOUNDED MOTOR VEIDCLE
INVENTORY CONTROL SHEET
Report Number: Date: <j.- 7 / s Time: b SC ;:>.fh
Vehicle Operator: Dl'r" i /)YI'!" l"</'.1'"/J-J '
Registrati9J! Number: 3 V )_: $ g Scite: (11 :'.\: Make: fa 1?' 0
Model: CJ. 5 0 Year:" Vin#: ________ _
Location of where inventoried: I <?1J 1 - ;{ _,. f :JO
Interior/Exterior Damage
Roof: V--
Rear: /
Windows: _____
Lights: ____ _
Right: ..,/ Wheels/Tires:
---t.<'--------------
Other:
Electronic Equjpment (presence/condition)
Built-in: v After Market: Am Radio:
--cc-----
AM/FM Radio- Cassette: CB Radio: CD: ___ _
Mobile Phone: TV: Other:
Glove Compartment/Console Qist all articles, containers & contents & condition):
u, 1 A Or'i' -
S,e;it Area-Front/Rear (list aj) articles, containers & contents & condition): .
fecf:S,qW,. C P'l., h(lcf-c . .qw , 114 Ooi C hec l: hao/,y c (
1
() hc:ri!ZC:>,
Trunk (list all articles, containers & contents & condition): Spare Tire: _____ _
Jack: Toolbox:--------------------
h J 1 iJ
Valuables of Note:
Reason for Tow: Accident _____ Arrest \7
Other
Inventory Officer: D \.W JV) i "'S
0
i'r"-'I
Supervising Officer: CJ
Additional Comments:
/
Abandoned ____ _
l.D.# 3'l.fo
l.D.#
---------------------
The Mission of the Sturbridge Police Department is to work in partnership with the Community to protect
life and property, solve neighborhood problems, and enhance the quality of life in our town.
The Town of Sturbridge is an Equal Opportunity Organization
Exhibit Page 20
TOWN OF STURBRIDGE
POLICE DEPARTMENT
Office of the Chief of Police
THOMAS J. FORD, III
346 Main Street, Sturbridge, MA 01566
Office (508) 347-2525 Fax (508) 347-7904
Sturbridgepd@charter.net
Name: //lu // c-'1
Last
Miranda Warning:
Statement of Rights
First
1. You have the right to remain silent.
Middle
2. Anything you say can and will be used against you in a court of
law.
3. You have the right to talk to a lawyer for advice before we ask you
any questions and to have him/her present with you during
questioning.
4. If you cannot afford a lawyer, one will be appointed for you before
questioning if you wish.
5. If you decide to answer questions now without a lawyer present,
you will still have the right to stop the questioning at any time until
you talk to a lawyer. v'.
6. DoyouLllltlerstand-what I have readto you? 11' .I
7. Having these rights in mind do you wish to talk to me now? __jj!_!:!.
RIGHT TO A TELEPHONE
General Laws Ch 276, Sec 33A: The police official in charge of the station or other place
having a telephone wherein the person is held in custody, shall permit the use of the
telephone at the expense of the arrested person, for allowing the arrested to co=unicate
with his family or friends, or arrange for release on bail, or engage the services of an
attorney. Any such person shall be informed forthwith upon his arrival at such station or
place of detention, of his right to use the telephone, and such use shall be permitted
within one hour thereafter.
lJ#i Z:. ~ f u e
The Mission of the Sturbridge Police Department is to work in partnership with the Community to protect
life and property, solve neighborhood problems, and enhance the quality of life in our town.
The Town of Sturbridge is an Equal Opportunity Organization
Exhibit Page 21
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Video Thumbnails
Exhibit Page 22
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