X0306 4 2017-09-21 0 0000319016 Fuse Medical, Inc. FZMD 0001718878 Kalra Ricky Raj S. 5425 W SPRING CREEK PKWY SUITE 133 PLANO TX 75025 1 0 0 0 Common Stock 2017-09-21 4 A 0 65000 0.78 A 65000 D Common Stock 2017-09-21 4 A 0 1000000 0.78 A 1065000 D On September 21, 2017, the Reporting Person was granted 65,000 shares of the Issuer's restricted common stock, pursuant to the 2017 Equity Incentive Plan of Fuse Medical, Inc. (incorporated by reference to Exhibit 99.2 to the Issuer's Form 8-K filed on April 6, 2017 (File No. 000-10093)), which will vest and cease to be subject to forfeiture (i) on the September 21, 2018, or (ii) in accordance with the vesting provisions of the Restricted Stock Award Agreement (incorporated by reference to Exhibit 10.1 to the Issuer's Form 8-K filed on October 10, 2017 (File No. 000-10093)). On September 21, 2017, the Reporting Person was granted 1,000,000 shares of the Issuer's restricted common stock, pursuant to the 2017 Equity Incentive Plan of Fuse Medical, Inc. (incorporated by reference to Exhibit 99.2 to the Issuer's Form 8-K filed on April 6, 2017 (File No. 000-10093)), which will vest and cease to be subject to forfeiture in accordance with the vesting provisions of the Restricted Stock Award Agreement (incorporated by reference to Exhibit 10.2 to the Issuer's Form 8-K filed on October 10, 2017 (File No. 000-10093)). /s/ Ricky Raj S. Kalra, M.D. 2017-10-10