Document Page: First | Prev | Next | All | Image | This Release | Search
File: 102896_aug96_decls1_0019.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
06:53: PATIENT FILE 10/27/90
PERSONAL DATA - PRIVACY Ar@l OF 1974
13. , i@DE: A
ly #: 029BAO51,) 2@ SSAt%': 3. PRECEDENCE: R
NAME; 18. AUTHORIT
4. STAT: N'Ll GRADE: 003 6. AGE: 34Y 7. SEX: 'I B. WT: 165 9. READY DAJE: 'L98
10. ISO: I'@. PORI 12. SPEC CATT
14@ REA.S RcB,, DS 15, DAIE LAST VISIT: 16@ CLASS: 3A
11. ACCEPT P@YS: 5 U.S.C. 552 (b)(6) 19. APPT/SUPG DA T : NO
@E
20@ APPROV AUIH: 21. CANC/INC, 22. VALID: L@',K I Y4
23. FITF OPIS: A5!50 USA DISPENSARY DHAHRAN 24. TCAO DRIG: O'CDR
26. ICAD DEST: EDAF
,,7 @ M-- DSPEC 1: SSE 28. DIAS l@ 7890 ABDD'iil.NIAL PAIx'
29. IED SPEC '-?: -@0, DIAS 11;
31. tlic'D SPEC 3: 32. DIAS 3:
p
-)2A. PROCEDURE:
33. SPEC DIET; MI 34. IV:
35. 02/LP@i: @4 36. SUCT: N 37. Nfz TUBE: N 38, RESP: N' 39. FOLEY: 1,@ 40. STRYV.ER: N
41. TN' D:N 42. TRACT: N 43. Ir@aDi N 44. CAST/LG'@; N 45. TRACH: 46. MON: N
. Du
71. PT BAG TYPE@ LNIB 72@ PT BAG TAG 73. PT BAB ]iJT:
47. S'U'PP INFO: 'u'SS O'BRIEN REPORTED BY
S'JB-AREA
48. MAX C,NRI-E STOPS: Y / 7 49. MAX # RONIS: Y 9 50. ALT REST/riAX HT: N
53. INPATIENT: Y54. SPEC PROart VA DRUG ALCOHOL @iT NONE X 55. VA CODEZ
56. ADiMlil/OVERSEAS:
58. VITAL gloiN.S(T iMP/PULSE/RESP/BLOOD PRESS): 096.4 801 61 1 220 1 88
1 E
59. HGB@ 60. HCT: 61. ABB@ / DATE TAK',N.
62. WBC: 63. SI/VSI: 64. MEDICATIONS: NONE
67i. HT STORY; SURGERY ON' 10 @ICT 90. P'CRE-BLADDER ABCESS.
00 000 OOAIO 68. t4ARD#/PH#: 000 / 000 000 0000
69. REPORTED BY: MARCHAtiT 70, PH#: 000 0000
74, ATTENDANT NAME 1: 771. STATUS: 76. GRADE:
77, ABET 76. SEX: 'OA. WT@ 79. DELATT ONSPIP TO PATIENT:
80. BAG TYPE: 81. BAG TAG 92. BAG WT:
1
83, ATTENDANT NAME #2: 84. STATUS: 85. BRADE;
86. ASc@: 87. SEX: 87A. WTt 86. @RELATTONSHIP -ig PATIENT2
89@ BAG TYPE- 90. BAB TAG 91. BAG WT:
?2. TRANS F,'RIG PHONE EXT:
91 TRANS DES' @'HDN'c@ 4': EXT:
94a ETA ORIC MTF(DAiE/TIME). 000 95. ETA DEST iN!TF(DATE/TIV.,E)@ 000
97@ OHER COMMENTS:
51. @I.SIN #: 0000/298 52@ RON LOC@
57. VALIDAT D BY/REA.9 FOR HIGHER PRECEDENCE:
IE
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