PATIENT FILE 29 OCT 90

File: 102896_aug96_decls1_0022.txt
Page: 0022
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:        03                                            PATiE,\'[ FILE                                               10/29/90
                                                      PL@RSO@IAL DATA - PRIVACY ACT OF 1974



                                                                                                                           13. RODE: A
                                                              i8. AUTHORITY #: 0299AO63 'I. SSAN: M                        3.  PRECEDENCE: R
       4,  STAT:   All            5. GRADE: E03               6. AGE! 29Y            7. SEX: il          S. 'w'T: 192      9.  READY DATF-:@ 299
       10. ISO:                   11. POR:                                   1                                             12. SPEC '@AT:
       '4@ PEAS REG: DS           15. DATE LAST VIS!TL        5 U.S.C. 552 (b)(6)                                          16@ CLASS: 3A
       17, ARCE@T PHYS@        JMRO                                                                                        19@ APPT BURG DATE: NO
       20. AFPROV   AITH:                                                        21@ 'upNC/T        NC-                    22, VALID:                   LMK    Y7
       23. itTF ORIG: 45150       USA DISPENSARY DHAHRAN                                                                   24. IP@AD OR     TG: OC@DR
       2@@@ r.,TF DEST: A5030     FRANKFURT ARMY RES NED                                                                   26. !CAD DEST:       EDAF
       27. MED SPEC 1: ES@-       28. DIAG 1: 1910        MALIGNANT NEOPLASM     OF CEREBRUM,       EXCEPT LOBES AND VENTRICLES
       29. ivc,D SPEC 2.          30. DIAS 2:
           @iED SPEC 3-           'o2. DIAS 3:
       2A. PROCEDURE:
       33. SPEC Dlcll:         NI                                                7,4.  Lv!
       35. 02/LPM- %,' 1          36, SU'@T:     N        37@ NS TUBE: N         38.   RESP: N                        39. FOLEY:            N   40. STRYKER: KI
U@,:      N         42. TRACT: N            43. IN.ED: N           44.   CAST/LOC: N                    45. TRACH:            N   46. i@DiN: N
       71, PT BAB TYPE: NB                                72. PT BAB TAG                                              73. PT BAB @IT:
       47. SIJPP INFO: 497 TRANS FORT LEWIS, WA                                                              REPORTED BY
       5Tu MAS,@                  *****DS***
       Is. MAX ENRTE STOPS: Y / g                         49. MAX # ROi\,@ Y     1 9                                  50. A',T REST/@'iAX HT: N
       53. 'NPAIIENIT: Y          54. SPEC PRO@        VA     DRUG       ALCOHOL       WT           NONE X            55. VA CODE:
       56. ADi4IiN/GVERSEAS:
       59@ VITAL SIGNS(TEiMP/PULSE/RESP/BLU'DD PRESS): 098@O /                 60    / IS /         120  80
       59@ HC-R:                  60. 4Cj:                61. ABB:          I          I                 DATE TAKEN:
       62.                        63. SI/VS!:             64@ ITDICATTON.S: NONE       REPORTED
                                                                       1




       6@l, HISTORY: PA        TNF LL MASS LEFT  THIOP, WHICH HAS INCREASED IN SIZE. PATIEN, NEED
                               @ . u
       8 M.RT/CT AND POSSIBLE SURGERY
                               1








       66, ATT P@4YS; MAJ NLIKICH                67. PH : 000 000 0000                              68.  WARD#/PF,#; 000 / 000 000 0000
       69. REPORTED BY: 'UIJIDD                                                                     70.  PH#.: 000 0000
       74. ATTENDANT NAME #lv                                                                       75.  STATUS:                            76. GRADE.
       77. AGE:                                  76. SEX:                78A. 6'Ti                  79.  RELATIONSHIP TO PAT       TETIT:
       60, BAB TYPE:                             GL. BAG TAG                                        82.  BAG WT:
2:                                                                   84.  STATUS:                            85@ GRADE:
       86. AGE-                                  87. SEX;                87A. ;4T:                  88.  RELATIONSHIP TO PATIENT:
       89@ BAG TYPE:                             90, BAG TAB                                        91.  BAG @IT:
       92. TRANS ORIS PHONE                            @XT@
       93@ TRANS DEST PHONE                            EXT:
       9@'@. ---IA DRIS @1,TF(DATE/TIF.-E)@ 000                                                     95.  ETA DEST MT'r-(DATE/IIMcl): 000
       97. OTHER COMMENTS:



       51. @.SN #t 4'23/299                                                                         52, RON LOC:
       57. VA'"TDATED BY/Rc@AS FOR HIGHER PRECEDENCE:
       96. AIRCRACT TTINCRA@RY@

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