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File: 102896_aug96_decls1_0021.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@-j4@46 PATIc T FILE 10129/90
,IN,
PERSONAL DATA - PRIVACY ACT OF 1974
13. i@'iODc@: A
18, AUTHORITY #- 0299AO62 2. ESAill: 7. PRECEDENCE: R
4. STAT: Al' GRADE@ E04 6@ ABE: 20Y 7. SEX: M B. t4Ti 160 9. READY DATE@ 299
10@ ISO: li. P'uR: 12@ SPEC CAT:
14. R-@-AS REG: DS 15. DATE LAST VISIT: 16. CLASS% A
17@ ACCEPT PHYS: Ji4Frt. 5 U.S.C. 552 (b)(6) 19. APPT/SLiRG DATE: KID
20, APPROV AIJTH: 21. CANC/INIP@: 22. VALIDT LVIK I Y7
23. M'F 0016,. A5'q.0 USA, DISPENSARY DHAHRAN 24, !CP.O U@RIS: 07tDR
25. MTF DEST@ F5070 USAFRriC WIESBADEN GE 26, ICAO DEST: EDAF
27@ NED SPEC It V@iil 28. DIAG 1; 49390 ASIHMA, UNSPECIFIED TY,E, STATUS AST,@'V(ATICUS NOT MENI@ONED
29. 4tED SPEC 2t 30. DIAS 2@
31@ F-.'@D SPEC 'It 32@ DIAS 3;
2A, PROCEDURE:
3@@ SPEC DIETT NI I
@4@ V:
35. 02/LPM: %I '@<6. SUP@T@. N' 37. NC TUBE: 38. REEP: N 39. FOLEY: N' 40, STRYKER: N
41, INP.IJB: N 42. I ACT: N 43. TMED: N 44. CAST/LGC,. N 45, TRACH: N' 46. MON: N
.R 1
7'4. PT BAB TYPE-. @IB 72. PT BAG TAB 73. PI BAG WT-.
47. SUPP INFO: E CO 407TH TRANS 82 ABil FORT BRAGS, NC REPORTED BY
CHAMPION MAIN ***DS***
48. VIPY ;-:NRTE STOPSI Y / 9 49. MAX # RDNS- y 9 50@ ALT Rc@st/MAX ',@T: N
56-. INPATIENT: N 34, SPEC PROG- VA DRUG ALCOHOL W'T NONE X 55. VA CODET
56. ADMlx@'/GVERSEAS@
58. VTT L SI@qN'S(TEMPIPULSE/RESP/BLOOD PR' S); 096@8 66 14 / 116 72
.A Cs
59. H@rD: 60. H@@Tz 61. ADG: DA@E TFVKEN.:
6@'. 'ABC: 63. STIVSI: 64. @,EDICATION@ VENTOLIN I - 2 PUFFS DID, PREDNIZOVI
I I
NIE 20MG BID, ERTHROFYCIN 250 M@r PO OID
6i. HISIORY,. OVER 2 '@@IEE@KS DF "WHEE2!NG". UNABLE TO FUNCIIOIN IN THIS AO@R@
67. PH#t 000 000 0000 68@ WARD4/PP@#: 0 1 000 000 0000
69. REPORTED BY: GUIDO 7@ pH#: 000 0000
74. ATTEt\'DAN, NAME #I: 7'@@ ST US; 76, 6@RADE-
.AT
77, ABE: 78. SEX-. 78A. 'AT: 79@ RELATIONSHIP TO PAi!ENTi
80. GAS TYPE: 81. BAG TAG 4: 82, BAB V.'T:
83, ATTENDANT NAME 42; 84. STATUS: 85. GRADE!
86. ACE% 87, SEX: 87A. W7i: 88. RELATIONSHIP 10 FATIE@T:
69, BAG TYPET 90, BAB TAG 91. PAS @iT:
?2. TRANS ORIS PHONE 4; EY.T;
93. TRANS DEST PHONE #: EXT@
94. ETA @URIG @,TF(DATE/TIME). 000 95. ETA DEBT MTF(DATE/TIME): 000
,7. OTHER CDYYTENITS,
51. VISN- #-@ 4123/299 52, RON LO'U:
@7. VAI-IDAT@ BYIREAS FOR HIGHER PRECEDENCE:
.ED
96. AIRnuRAFT ITTNR ARY: I I
CR
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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