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File: 092396_aug96_decls14_0014.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
**** PPi!E,@4T FILE **** 12/29/90
PERSONAL DATA - @r@RiVACY ACT OF 1074
5 U.S.C. 552 (b)(6) 13. ilODc@: A
'8, AU@HORI, C) 61AO'16 2. SSATN: 3. PRECEDENCE: R
i. NAME: 'TY ih
4@ ST AiA'2 5. GRADE: @@04 6. AGE: 43Y 7. SEX: H S. WT: 170 9. READY DATE: 361
AT,
10, ISD.@ IL. POR: 12. SPEC @PAT:
'4. REAS RED: DS 15. DATE LAST VISIT:
i 16. CLASS@ 3A
i7. ACCEPT PF@YS: 19@ APPT/SURG DATE: NO
20. APPROV A'CIH: 21. CA@4'@/INC: 22. VALID: I L@ll@ f Y5
23. riTF ORIS: A5150 USA DISPEt4SA.Dy DHAHRAN 24. ICAG CRIB: GEDR
25. M-TF DEST: F507(3 USAFRriC WIESBADEN BE 26. ICAD DEST: F:DA.F
27. i@iED SPEC 1: MMU 28. DIAG 1: 49390 ASTHMA, UNSPECIFIED Type:
STATUS ASTb,tiATI-,US NOT MENTIONED
29. Mc@D SPEC @0. 30. DIAS 2,
31. 'DIED SPEC 3- 32, DIAB 3:
31@A. P.ROCEDLIRE@
3'@ SPEC DIET: i@4 34. IV:
@q 36. SUCT: t,, 37. NG TUBE: ti 36. RESP: N 39. FOLEY; N 40. STRYKER; j%l
02/LPM-. N /
41, IN@,iIB: N 42. iRACTi N 43. IMC@D: N 44. CAST/LGC: N 45@ TRAC@'; N 46. MON: N
71@ PT BAB TYPE: NIB 72. PT BAB TAG 73. PT BAB '@'T:
47@ lt4FOi 21ST TAA Cgi'l, IND.TAiN'APCLTS, 1 i%l //'73 KRUII
//BS EVACI/
48. MAX EC@RTE STOPS: Y1 9 49. MAX # RON@ Y 1 9 50. ALT REST/MAX @4T: N
53. INPA.TIEKIT@ Y @@4. SPEC PROBT VA DRUG ALCOHOL @@T NONE X 55. VA COD-:
56. ADi'IIN/OVERSEAS;
q
@g. VITAL SiGiNS@TEilIP/PULGE/@9E@oP/BLOOD PRESS): 097.8 80 / 16 112 88
59, PGB: 6t@. HOT: 61. ABB: DATE TAKEN:
62. t4BC: 63. S@/Vgi: 64. MEDICATIONS: PRED@MIZOj%iE 40riG O.DAY PO; PLOVE,%ITIL
INHALER DID PRN; THEODUR 20011'u PO BID
65, HISTORY: ASTHMA NORMALLY CONTROLLED BY TH--.OPHYLLiNE INHALER. BETHAGONISTIS
AND !NHAILED STEROIDO@, NOW REQUIRES SYSTEMATIC STEROIDS FOR CONTRC-',.
: 999 99@ 999 9999
67, REPORTED BY: SGT ABBOTT 70, PF,#: 999 9999
74. ATTENDANT NAME #I: 75. STATUS: 76. GRADE:
77. AGE: 76. SEX@ 76A. WT: 79, RELATIONSHIP TO PATIENT@
80. BAD jy@o@C.- Bi. BAB TAG 82, BAB WT,
8 .ATTENDANT NAME 42: 64. aTATUSt 85, GRADE:
86. AGE: 87. SEX; 67A. WI: 88. RE'@AIIGNSHI@ TO PATIENT:
89, BAB TYPE: 90. BAG TAB i@k: 91. BAD R@-:
92. TRANS ORIri PHONE EXTT
93. TRANS DEST DHQN@t EXT@
94. ETA N@RIS tIT-(DATE/TIrE): 000 .1 9@@. ETA DESI @tT @DA' /'IiNP): 000 I
F iE I
@7. OTHER COMMENTS:
51. Ytc;iN #i Ofloo/361 52. RON '@oCi
57. VALIDATED BY/REA@o FOR @'ICF@ER PRECEDENCE;
96. AIRCRAFT ITINERARY:
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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