Document Page: First | Prev | Next | All | Image | This Release | Search
File: 092396_aug96_decls14_0022.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
05.-44.17 PATIENT FILE
PERSONAL DATA - PRIVACY ACT OF 1974
5 U.S.C. 552 (b)(6)
MOE;E: A
18. AUTHOR
NAM-,; ITY 0,; V@,61A@o'l 2. SSAN: PRECEDENCE: R
4. STAT; All GRADE! E06 6. AGE-. 34Y 7. SEX: il S. v,'T: 218 9. READY DATE: 361
10. ISO., 11@ paq. 12. SPEC @AT:
14. REAS REG: DS '5. DATE LAST VISIT: 16. CLASS: 3A
17. AP EPT P'YS; 19. APPT/S@@IRS DATE: NO
20@ AP@OROV AUTHI 21. CANC/INCi 22. VALID: L@!'N' Y5
13. MTF GRTG: A5"jo U64 DISPENSARY DHAHRAN 'L4. ICAO DRIG@ OEDR
25. MTF DEST@ A@@940 2iND GEil HOSP LAINDSTUHL 26. !CAD DESTT EBAR
27, M-'-D SPEC 1: MMO 26. DIAG 1: 20200 NODULAR LY@.,PHOMA, UNSPECIFIED SITE
29. @IED SPEC 2- ESL: 3.0. DIAS 2- 20200 NODULAR LYPiPHCj'OiA, UNSPECIFIED SITE
31. 'ii.ED SPEC 3t 32. DTAG 'O:
32A. PROCEDURE:
3'@. SPEC DIET: N/ 34. TV:
02/LP@'i@ N. 36. Sl@'r@T@ N 37. N.5 TUBE: N 38, RESP: N 39. FOLEY: N 40. STRYKER: N'
41. TNCUB@ N 42. TRA@@TI N 43. Ir..c,D: N 44. '@AST/LGC: N 45. TRACH: N 46. N
71. PT BAG TYPE: @iB 72. PT RAP TAG 73. PT GAS t@!T:
47@ SUPP !NcG: HH@C IST COS COil, FIT B@ACO, 14C //i73 @',Rn@ll
//8Fj EVA@@//
48, MAX ENRTE STOPS@ Y 1 9 49. MAX # RWN'D: Y / 9 50. Al@T REST/MAX HTA N
13@ INPATIENT- Y 5@,. SPEC PDOG@ VA DRUG ALCOPOL WT NONE X 5@, VA CODE:
. OVERSEAS:
Q6. ADMTNI/-@
53. VITAL SIGNS(TErP/PULSEIRESP/BLGOD PRESS); 097.2 60 / 14 100 70
59. HGB; 60. HOT: 61@ AB'u@ I DATE TAKEN:
62. NBC: 63, 611 l@ 64. NONE
@5, HISTORY: T6'0 MONTH @@STCIRY PRNCPESSIVE, @N'O@.1 TENDI:R 14.ASS LEFT ARM. N"@114 SIZCI
OF GRAPEFRUIT. NODES PALPABLE IN GRO@,ITNG, N-P TO OXILA OER RIGHT HILSAR NOD
ES.
66, ATT r'HYS: GAMBLE 67@ PH.#: 9@9 999 9999 68, 14ARD#/PH#: 999 / 999 999 9999
69@ REPORTED -BY: SGT ABBOTT 70, PH4: 999 9999
73, STATUS: 76. GRADE:
77. AGE: 78, SEX: 76A. W;T: 79. RELATIONSHIP TO PATIENT:
Sf). BAG TYPE. 81. BAG TAB 82. BAG WT:
83. ATT NDANT NAME #2: 6'. STATUS: 85. GRADE:
,E
86@ AGE: 87. SEX: 87A. @.4T: 88. RELATIONSHIP TO PATIENT:
89. BAB TYPE; 90. BAG TAG 91. BAG @IT:
92. TRANS OPTB
,@ PHONE EXT:
93. TRANS DEST PHONE EXT:
94. ETA ORIG ilTF@DATE/TIME)t 000 f 95, ETA DEST MTF(DATc-/TVE)i 00
91, OTHER COMMENTS.
51. MSN #: 0000/361 Yz. RON LOC:
57@ VALIDATED BY/REAS FOR HIGHER PRECEDENCE:
9,@. AIRCRAFT ITIN---RARY@ f
Document Page: First | Prev | Next | All | Image | This Release | Search
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