Continuity mistake: When Turk and Elliott are in the line at the cafeteria, you can see that Turk has two plates on his tray and Elliott has a juice box on her tray. When they turn around at the end of the line Turk has just one plate on his tray and the juice box on Elliott's tray is also gone.
Continuity mistake: When the janitor is speaking into the stethoscope, his right elbow is on his knee and his left hand is on the mattress, when it cuts closer, his elbow is further up and his hand is next to his leg.
Answer: No, it was a fake, they used a stamp.
It is real.