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File: 092396_aug96_decls14_0013.txt
Subject: PATIENT FILE
Box ID: BX000482
Document Number: 2
Folder Title: MEDSTAT - SITREPS DEC 90 4 OF 6
Folder Seq #: 8
Unit: ARCENT
Parent Organzation: CENTCOM
FATTET,'T FT, E i2,-29/90
r, JAL DATA - PRTVAPIY ACT OF 1974
5 U.S.C. 552 (b)(6)
13. rnD7: A
NAME: 'S. AUTHORITY #: @,36OA05@ 2. 'SAN: 'O. PRECEDENCE: R
4. STATT All 5. GRADE: E05 6, AGE: 38Y SEX; M 'O. @IT: 170 9. READY DATE; -@60
io. I @Ll: 1. PDR.- 12. SPEC C4T.-
'44. REAS RES: DS 15. DATE LAST VISIT: 16. CLASSI 2B
17. ACCEPT PF@YS: 19. APP-,/SURB DATE: 140
20. APPROV AUTH: .I. 22. VA!-IDI TJH Y5
2,'). f@iTF BRIG: A5'@@o USA DISPENSARY DHAHRAN 24. ICAO CRIG: DEDR
25. M-tF DEST: F5070 USAFRilC WIESBADEN BE '@6. ICAL'J DEST: EDAF
27, TIED SPEC 1: SOO 26. DIAG 1: 71946 PAIN IN! JOINT INVOLVING LOWER LEB
2?. !qED SPEC 2. 50?@@A 30. DI.40' 2: 7i946 PAIN la\' j@l@NT INVOLVING '@014ER LL's
31: VIED SPEC 3: 32. DIAG 3:
32A. PROCEDURE:
TV:
35. 02/'@pO@: N o6. SU@,TZ N 37@ NG -$UBE: N 38. R-tsP: N 39, FOLEY: N 40, STRYKER: N
41. INCUD@W N 42. TRACT: 43. IFZ-D: N 44. CAST/LDr-: 4 45. TRACH: i% 46. N
71. PT BAG TYPE: NB 72. PT BAG -.AG 73. PT BAG WTt
47, SliPP Ni FO: 366 EFE, MT HOME @.FB, IDAHO 11@OUB J@!RCII
"/FLEET ql/l
49. "lAX ENRT-T STOPS3 Y 9 49. I@IAX @ RONS: Y 9 50. ALT REST/,@'IAX HT@ N
53. INPATIENT: Y 54, SPEC PROG: VA DRUB ALCOHOL @,T NONE X 55. VA CODE:
36. AD@ITN/'uVERSF-AS;
58@ VITAL SIGNS(TE@IP/Pl-"@SE/R---SP/BLO'uD PRESS): 097.6 70 12 / 120 1 81,
39. EGB: 60@ HOT: 61, ABS: / DATE TAKEN,:
62, NBC: 63, SI/VSli 64. MEDICATIONS: COLECTINI @IOVB BID
65@ HISTORY: CHRONIC RIGHT KNEE PAIN ADMITTED 25 DE". PAIIE@N'T REQUIRES DIACNOST
10 ARTHROSCOPY, OUT OF AOR FOR POSSIBLE IMEE.
66. AT T P YS: ' ASSICA 67, PH4: 999 999 9997 68. 14ARD#IPH#: 997 999 999 909@
, H PR
6'@ REPORTED By: 96r ASPOTT 70. PH#: 999 9999
74. ATTENDANT NAME #I: 7-J. STATUS: 76. G@RADE@.
TO PATIENT:
go. PA B TYPE: 'I. BAG TAG 82. BAB i4T.
1. 0
8 @ ATTENDANT NAME #9: 84. STATUS: 85. RADE:
86. AGE; 87, SEX! 87A. WT: 68. RELATIONSHIP 10 DATIENT:
89. BAB TYPE: 90@ BAB TAG 91. BAG r.T:
9.@. TRANS OR@'S PHONE EXT:
r%. TRANS DEBT PHONE EXT;
94@ ETA CRTG MT (DATE/TI[lc-),. @O'@) 9@. ETA DEST M- (DATEITI,'IE); 000
.F - I IF
97, B-IK'TR COMMENTS:
51. @SN #: 00001'60 @@2. RDiN LOC:
57. VALIDATED BY/REAS FOR HIGHER PRECE@uEK"uE@ f
96. AIRCRAFT ITINC ARY: I
. @IR
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Document 30 f:/Week-32/BX000482/MEDSTAT - SITREPS DEC 90 4 OF 6/patient file:09069614064231
Control Fields 17
File Room = aug96_declassified
File Cabinet = Week-32
Box ID = BX000482
Unit = ARCENT
Parent Organization = CENTCOM
Folder Title = MEDSTAT - SITREPS DEC 90 4 OF 6
Folder Seq # = 8
Subject = PATIENT FILE
Document Seq # = 31
Document Date =
Scan Date = 14-AUG-1996
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 06-SEP-1996