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File: 102896_aug96_decls1_0008.txt
Page: 0008
Total Pages: 46

Subject: PATIENT FILE  29 OCT 90                                         

Box ID: BX000482

Unit: ARCENT      

Parent Organization: CENTCOM     

Folder Title: MEDSTAT - SITREPS  OCT 90  3 OF 4                                                               

Folder SEQ  #:         16

Document Number:         10



                  06:49:0-@                                                 PATIENT FILE                                                        101,@9/90
                                                               PERSONAL n,AT - PRIVACY ACT OF i974
                                                                           .A



                                                                                                                                          13.   @IODE: A
     1.           N!A,,qE;                                          18, AUTHORITY @: 0299AOI9 2. SSAN:                                    3@    PRECEDENCE: @R
     4.           STAI: All          5. GRADE: E02                  6. AGE: I.Ov           7. SEX@ @@i              S. 'tlT-        185   9.    READY DATE: 299
     10,          TSO@               'I. POR@                                                                                             12.   SPEC CAT:
     14.          REAS RES: DS       IS. DATE LAST VISIT:                                                                                 16.   CLASS: 3A
     17@          ACCEPT PHYS:       JFJRD                              U.S.C. 552 (b)(6)                                                 19.   APPTISLLRB DATE: NO
     20@          APPROV AUTI4:                                                          21. @@ANP,,"N'u:                                 22.   VALID:                    LikiK    Y7
     23.          IJT L9RTO: A.5'50  USA DISPENSARY D@@' AN                                                                               24.   ICAO DRIG: OEDR
                  IF
     z5.          TITF DEST- F@@070, US@,FRM'u Vj'IESBADEt@ GE                                                                            26.   ICAO DEST:       EDAF
     27.          MED SP-EC 1: M@iT  'IS. DTAG 1: 4017         ESSENTIAL HYPERTENSION, INDS
     29.          MED SPEC '4: MO@l  30. DIAG 2: 4GO9          PNr7'u'@NIA DUE 10 VIRUS i@OS
6        CELLULTTIS AND ABSCESS OF LEG, EXCEPT FOOT
     32A. PROCEDURE@
     ,3.          SPEC Dic@T: NI                                                           34.  IV;
     35.          02/LPj'l: N        Z6. SUCT-                 N37. NS TUBE: tl            36.  RESP: N'                            39. FOLEY:             N     40, STRYKER: N
     41.          INCUB.  N          42. TRACI: il             43, IMED: N                 44.  '@ASi/',OC,. N                      45. TRA'@H:            N     46. VION: N
     71,          PT BAB TYPE,       NB                        72@ PT BAG TAG                                                       73. PT BAG       'hT:
     47.          SUPP -INFO. *****DS*** 1-19 IRANS FT ELITIS VA

     46.          r@,AX E@'.RTE STOPS: Y / 9                   49@ MAX @, RONS: Y             9                                     50. ALT REST/IIAX HT: N
     53@          '@"PATIENT@ Y      54. SPEC PROS:            VA   DRUG        ALCOHOL         WT      NONE X                      55@ VA CODE;
     o6.          AD@tTN/Okit-RSEAS:
     58.          VTT ' SIG,%ig(Tc-14,P/PULBEIR@ P/B' OD       PRc S): 09&0            64       18 /     10         110
                  iA.L                       Is                @o @s                                      Do
     59.          PGD:               60@ 'dCT,,                61. ABG-                                             DATE TAKENT
     62.          @AD@               63. SI/VSI:               64, VEDICATIONS@ TETR.Af-'Y@@LYN 50 m@,              AD QID , HUMIDID
     650MG PA     BID, ifiDROALL 2OVG PA TIC,                  PRGCAR-IIA 2OMP, PO TTD


     65. '@'.IST  RY; ADMT           IT FOR @'El@LUL           TS OF LEG DCVEI P@NU AND H.YPERTENSToi%', CELL AND PNU
                  .0
     E UNDER CONTROL BUT HYPER POORLY CONTROL.








     66@          AT' PH@YS: @IAJ T@,IUKTNE                    67, PH#: 000 000 0000                                68. @IARD@c/PH#: 000        000 000 0000
@@150                                                                         70. PF@#: 000 0000
     74@          ATTENDANT i\'AM@c@ #1.                                                                            75. STATUS;                              76. GRADE%
     77.          AGE:                                         78. SEX:          76A. 'WT:                          79.D   ATTOI
                                                                                                                       'El- @, 46HIP TO PATIENT:
     80.          DAG TYP@.2                                   Si. BAB TAG 'ff:                                     62, BAB WT:
     83.          ATTENDANT          #2,.                                                                           64. STATUS.-                             85. GRADE:
     86@          AGE:                                         87. SEX:          67A. WI:                           88. REL4TION,@IP TO PATIENT:
     69.          BAG TYPE:                                    90, BAB AC                                           91. 2@AS @IT;
     92.          TRAtig CRIB PHONE vg;                        EXT:
     93@          T ANS DEST PHONE                             'XT:
                  .R      I                                    m
     94.          PTA DRIS MTF(DATE/Ti,@E): 000 1                                                                   95. ETA, DEST MT@(DATE/TIME): 000
     97.          OTHER CO@@ENITS:



     5i.          i@iSN #:                                                                                          52@ RON LOC:
     57.          VALIDATED BYIREAS FOR HIGHER PRECEDENCE:
     96.          AIRCRAFT 7TW%cRARY:

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Document 46 f:/Week-32/BX000482/MEDSTAT - SITREPS OCT 90 3 OF 4/patient file 29 oct 90:10019616503417
Control Fields 17
File Room = aug96_declassified
File Cabinet = Week-32
Box ID = BX000482
Unit = ARCENT
Parent Organization = CENTCOM
Folder Title = MEDSTAT - SITREPS OCT 90 3 OF 4
Folder Seq # = 16
Subject = PATIENT FILE 29 OCT 90
Document Seq # = 10
Document Date =
Scan Date =
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 = 01-OCT-1996