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File: 102896_aug96_decls1_0026.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
07:00:09 **** PATI@uNi FILE **** 10/29/90
PERSONAL DATA - PRIVACY ACT OF 1974
13. MO@@i: A
l@ NAME: 18, AUT BRITY #t 030OA006 '@. SEA@
.H PRECEDENCE: R
4. SiAi@ All 5@ GRADE; c,05 6. AGE: 29Y SEX: I S. WT: 160 9. READY DATE: 299
10. 160; 11. POR: 12@ SPEC CAT:
14. REAS RES., DS '5., DATE LAST VISIT: 5 U.S.C. 552 (b)(6) 16. CLASS: 3A
'7. ACCEPT P,4YS: 19. APPT/SURS DATE: NO
20. APPROV AUTH: 2i. CANC/INC@ 22. VALID: MLE Y6
2'@@ MTF GRIS: A5!50 USA DISPENSARY DHAI,'IRAN 24. ICAO DR!GT OEDR
2'@. @MT DEST: A5040 2ND GEN HOSP LAt%[DSTUu '-)6. ICAO DEST: EDAR
IF @L
27. MED SPEC l@ MVIN 26. DIAG 1: 3469 MIGRAINE, UNSPECIFIED
29, @IIED SPEC 2: 30. DIAG 2:
31, VJED SPEC 3: 32. DIAG 3:
32A. PROCEDURE:
PEC DIET: N/ 34, TV.
35. 02/LPM,: N 36@ SUCT, 37. NG TUBE: N 38. N 39. FOLEY: N 40. STRYKER;
41. li%l@@UB2 N 42@ TRACT: N 43. IMED! N 44. CASI/1-OC: N 45. T AC@4: N 46. riu\i N
,R
71. PT BAG TYPEG NB 72. PT ';AG TAB 73. PT BAG WT@
47. SUPP TN.FG: 7TH GROUP 1IT4 BAT, 368TH-TC F] STORY VA REPORTED BY:
SUB AREA J@'IRO
f@@ @'@AX @--N@PTE 97iGPS: Y / 9 49. MAX 0 RONS: Y 9 @10. ALT REST/@IAX HT@ N
T
J3. @NPATIENT@ @14 54. SPEC PROS: VA DRUG ALCOHOL NT NONE X 55. VA ODDE:
56. ADMI@N/GVERSEAS:
58. VITAL SIc.NS(TErP/PULSE/,RESP/B"GDD PRESS): 098,6 75 14 138 70
59. HCB: 60. HOT: 61@ ABG; DATE TAKEN;
b-z' WBC- 63@ SI/VSI@ 64. @'@ED T@ATIONS:
riOTRIN 600 MG 96 HR AS NEEDED
65, 'n'lSiCRv: LONG @41ST OF ri!GRAN HEADA@@HES. NO RESPONSE 10 MEDICATION', RECOMMEND
riP-DIVAC.
66, AT" PHYS: BOTTOMY 67. PH : 000 000 0000 69. 14,'ARD#/DH*: 000 / 000 000 0000
70@ PH@: 000 0000
74. ATTENDANT NAME #I; 75. STATUS: 76, GRADE:
77. AGE: 78. SEX: 78A. 14T: 79. RELATIONSHIP TO PATIENT:
90@ BAB TYPE: 61. BAB TAG 92. BAG t4T!
83@ ATTENDANT NAME #2@ 84. STATUST 65@ GRADE:
C6. ACE: 87. SEXT 67A. 'vlT@ 88. RELATIONSHIP TO PATIENT:
99. BAG TYPET 90. BAG TAB 71. BAB WT,.
92@ TRANS ODIG PHONE 'CXT:
93, TRANS D'zS] PHONE EXT:
94. c@IA ORIG @'iTF(DATEITTMC)@. 000 95. ET DEST @ITF(DATc/TIME): 000
A
97, OTHER COil@'@Ei\'iS:
51. MSm 4@ 0000/299 @,2. RON LOC:
57. VALIDATED BY/PEAS FOR HIGHER PREPEDEi%'CE@
76. AIRCRAFT ITINERARY: 11
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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