Document Page: First | Prev | Next | All | Image | This Release | Search
File: 102896_aug96_decls1_0018.txt
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
06:52:07 **** PATIENT FILE **** 10/29/90
PERSONAL DATA - PRIVACY ACT OF 1974
13. riODE: A
1. 16. AUTP@ORIT #: 01@99AOO2 2. SSAN: 3. PRECEDENCE: R
ly
4. STAT@ All 5. @t, 6. Ar@'E@ 22Y 7. SEX: M S. WT@ 160 9. READY DATE: 'L98
10. ISO: 11. POR: 1 12. SPEC CAT:
14. R@cAS DEG- DE 15. DATE LAST VISIT; 16. CLASS: 3A
17@ A'LCEPI PHYS: 5 U.S.C. 552 (b)(6) 19@ APPT/SUIPB DATE: NO
20. APPROV AUTH: 21. CA@NICII@NCT 22. VALIDI CEA YA.
23, MTF OOIG, A51@@o USA DISPENSARY DHAHRAN 24. IP@pla OR',G-. Or'DR
21@. MTF DEBT-, A5040 z'\'D GEN HOSP LP.NDETUJL 26. ICAO DEST: EDAR
27@ MED SPEC 1: Mi@,N 28. DIAG 1: 3510 B@,LL'S PALSY
'9. MED SPEC 2: 30, DIAG 2:
'I. NED SPEC 32. DIAS 3:
32A. PROCEDURE-
@'. SPEC DIET: N/ 34. 'V:
3S. 02/LPM-. N' 1 '@6. SUCT@N 37. t,6- TUBE; \1 38. RT-SP: I 79. FOLEY: N 40. STRYKER: N,'
4'. liNCUB: N 42, TRACT: @i' 43, L@MED: N 44. CAST/LGC: N 45. TRACH: N 46. ?iON: N
71@. PT BAB TYPE: NB 72, PT BAB TAG 73@ PT BAG WTz
47@ BLIPP INFO: FT. BRAGS REPORTED BY
46,TH Vi@-D BriD.
48. VAX ENIRTE STOPS: Y / 9 49. MAX # RONS: Y 1 9 50, ALT REST/iNAX HT: N
53. I@,,PAI!Ei%'T@ i%l 54. SPEC DROB: VA DRUG ALCOHOL WT NONE X 55. VA CODE@
56. ADtOiLNIOVERSE.AS:
58. VITAL SIGN@g(TEMP/PULSE/RESP/DLOOD PRESS),@ 097.6 64 1 14 1 I',O 80
@9. p@SB; 60. @@'CT@ 61. ABG@ DATE TA.KEN@
62. WBE; 63. SI/Vgl: 64. MEDICATIONS; ARTIFICIAL TEARS OD
65. HISTORY: PAT TENT @"TH IDIOPATHIC BELLS PALSY RIGHT FACILA PARALYSIS.
66. AT-i PHYS: BRANDROLD 57@ PH@.- 000 000 0000 68, h'ARD#/PH#: 000 I 000 000 0000
69. REFO@0,'ED BY: MARC,4ANIT 70. PH4: 000 0000
A TE@DA,%-T @NAM7 41: 75. STATUST 76@ GRADE:
AT
77. froe,, 78. SEX: 78A. WT@. 79. RELP7104SHP TO PATIENTI
80, BAB TYDE@ 81, BAG iAG 62@ BAG 'AT:
33@ ATTENDANT NAME #2: 84@ STATUS-. 85@ GRADE,.
86. AGE: 87. Sc@x@ 87A. 88. RELATIONSHIP TO PATIENT:
89. BAG TYPE: 90. BAB TAG 91. BAG V,T:
92. TRANS DR16 PHONE #z EXT:
9-@. TRANS DEST PHONE #t EXT:
94, E-,A ORIG MTr7(DqTcl/TIME): 000 95. ET DEBT MTF(DA.TF/TIME)@ 000 I
97. OTHER COYiVi'zN'TS@
5'L@ VSN #; 0000/298 52. RON LOC;
57. VALIDATED BY/REAS FOD @GH---R PRECEDENCE: I
96. AIRCRAFT ITINERARY: I
Document Page: First | Prev | Next | All | Image | This Release | Search
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