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File: 102896_aug96_decls1_0025.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
06:59:46 **** DATIENT FILE ***@- io/@L9/00
PERSONAL DATA - PRTVA@ ACT OF 1974
I uy
c
13. M.01@A A
l@ NAME: 18@ A'u'T@qCRIIY 2. SSANI-M PRECFDENI@@E: R
.A
4. 9'T@ All 5, GRADE: E06 6. AGE: 31Y 7@ Sh-X; M S. WT: 175 9. READY DATE: 300
10. I
So. POR: 12@ SPEC CAT;
14@ REAS RED: DS i5, DATE LAST VLSII: 5 U.S.C. 552 (b)(6) 16. CLASS: 29
17. PP.YS: u'l@,RO 19, APPT/SUPG DATE: NO
20. APPROV AUI.H: 21. r-A\'C/ii\'C: 22. VALID:
23. riT;: CRIB-. A@@150 USA DISPENSARY DHAHRAN 24. ICAD CRIG: DEDR
25. @TF DEST- A@@070 FRAN FURT ARMY REG Mca 26. !CAO DEST@ EDAF
27. riED SPEC 1: MMrz 2B. DIAS 1: 53300 ACJJTE PEPTIC ULCER, UNSPECIFIED SITE WITH HEMORRHAGE
29@ NED SPEC 2: 30@ DIAS 2@
31. MED SPEC 3: 7@2, DIAS 3:
32A. PROCEDURE:
34, !Vi N/
35. 02/LPivi: N 36. SUCT; N 37. NPa TUBE: 39. RESP: N 39. FOLEY: N@' 40, STRYKER: N
41, INCUB- N, 42@ TRACT; N 43. IMED: N' 44. CAST/LG'@: N 45. TRACH: N 46. @,DN: N
71. PT BAB TYPE: NB 72. PT BAG TAG 73. PT BAB MT:
47. SUPP INFO: C CO 32 CAV FORT HOOD, TX RPORTED BY N
(V'4Y FLC,ET HOSP 5
48. MAX -PNRTE STOPS: Y / 9 49. MAX -@ RONS: Y / 9 50. ALT REST/MAX HT: iN
@3. INIOATIENT@ Y 54. SPEC PROB@ VA DRUG ALCOHOL @17 t,'ONc X 55. VA CODE:
56@ PDhllil/DVERSEAS:
@8. VITAL SIGNS(TEiIP/PULSF/RESP/BLODD PRESS)@ 098.4 068 1 16 124 70
59. P@OD, 60. HCTT 61. ABB- DATE TAKEN:
62. NBC: 63. SIIVSI: 64. MEDICATIONS: NONE
65@ HISTORY: STATUS POST V/P, STATUS POST Bll 1984 HISTORY OF RECURRENT P@'4D SI
NICE 1967 - NOW UNABL@- T VOMT
- .0 TO'@GRATE SOLID FOOD. FREQUENT NAUSEA AND @TIMG.
COMPLAINS OF CON@TENT STOMACH PROBLEMS.
66@ ATT PHYS: CAPT BARNES 67. PS.#: 000 000 0000 6& WARD@/PH4: 000 I 000 000 0000
69@ REPORTED BY@ GUIDO 70. PH#: 000 0000
74. ATTENDANT NAME #1@ 75. STATUS; 76. GRADE:
78, SEX: 78A. WT: 79. RELA[IONSHIP TO PATIENT:
80. BAG TYPE: 81. BAG TAG 62. BAB 'AT:
83. ATTENDANT NAME #2@ B4. STATUS: 8'0, GRADE:
86. AGE: 87. SEX: 67A. WT: 88. RELATIONSHTP TO PATIENT:
89. BAG TYPE: 90@ BAG TAG it: 91. BAB @IT:
92. TRANS ORIS PHONE 4: EXI:
?3. TRANS DEST PHONE : EXT:
94. ETA ORIG MT (DATE/TIME); 95. ETA DEST MTF(DATE/TIME):
,F
97. OTHER COMMP-NTST
51. MSN ft@ 0000/300 52, RON LOO;
57. VP.LIDA,ED BY/REAS FOR HIGHER PRECEDENCE:
96. AIRCRAFT ITINERARY:
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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