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File: 102896_aug96_decls1_0029.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
07:01:08 PATIENT FILE 10/29/90
PERSONAL DATA PRIVACY ACT OF 1774
13. I!IDDE: A
18. AUTHORITY 4t 2. SSAN PRECEDENCE: Fi
4@ STATI All 5. GRADE: EOB 6. AGET 43Y 7. SEX: M O. @lT@ 170 9. READY DAIE: 300
10@ ISO-@ 11. FOR: 12@ SPEC CAT:
i6. CLASS@
14@ REA.9 REG: DS IS. DAIE LAS' VISIT: 5 U.S.C. 552 (b)(6)
17. ACCEPT PHYS; JFRD 19@ APPTIEUR'U DATE: NO
20. APPROV AUTH: 2'. 22. VALID@
2'@. -,41,TF ORTC: A5!50 U' DISPENSARY DP.AJ A.%, 24. ICAO BRIG: OP-DR
oA @R
25@ V,@IF D@,91: A5030 FRANKFURT ARMY REG @',c,D 26. ICAD DES[: EDAF
C
,BITIS,THROMBOPHLtBITIS, SUPERFICIAL VESSELS, E
29. Yi;-:D SPEC 2i 30. DIAS 2i
31. rED SPEC 3: 32, DIAS
32A. PROCEDURE:
33. SPEC DTET: 34. IV: MI
3@@. Oll/LP@4@: N 36. SUCT: N 37. NG TUBE: N 38. RESD-. N' 39. FC'LEYI N' 40. STRYKER: N
41. IINCUB:N 42. TRACT: j@ 43 . T
,JMED@ N 44. CAST/LOC: 45. TRACH: N 46. rig@l@ N
71. PT BAB TYPE: ND 72@ PT TPS 73. PT BAG VIT:
47. BL@IPP INFO: HHC IST COS@10,11 FT BRAGG, iN'@ REPORTED BY
23 CSH
48, MAX C@NRTE STOPS: Y / 9 49. MAX RUNS: Y / 9 50. ALT REST/MAX Hit N I
INPATIENT; Y 'o4. SPEC PROB: VA DRUB ALCOHOL W,@ NONR: X 55. VA CODE:
@6. ADMIN/GkJERSEAS:
58. VIIIYL SIONS(TEMP/PULSEIRESP/BLC'uD PRESS)Z 098.6 070 / 16 120 80
59. PICB@ 60@ HOT: 61. ABS: DATE TAKEN:
6'z. 63, SI/VSI: 64. MEDICATIONS: NONE
V@, HISTORY: VEIN' IN 1977 WITH GOOD RESULTS. Oi\l PERMANENT U2 AND 1,2 PROFILE
I
"H.ICH. PREk)EN'Tg HIM FROM BEING FUNCTIONAL IN THIS THEATRE
66. ATT P@4YS: MAJ FABOLAK 67. PF.@rt 000 000 0000 68. IAARD#/PH#: 000 I 000 000 0000
69. REPORTED qY,. GUIDO 70, PH#; 000 0000
74. ATTENDA@,\Ii NAME 1: 75. STATUS: 76. GRADE:
77@ ASE- 78. SEX! 78A. '@4T: 79. RELATIONSHIP TO PVi TENT:
60. BAG TYPE. 81. BAB TAG 62. BAG WT@
. ATTENDANT NAME 4@4: 84. STATUS: 85. GRAD7tt
86. ASET 97. SEX: 67A. ',k'T- 88, RELATIONSHIP TO PATIENT:
S9. BAG TYPE; 90, BAB TAG #t 91. BAB 'ATt
92. TRANS ORIS PHONE EXT:
93@ TRANS DEST PHONE EXT@
94. ETA ORIS jMTF(DATE/TlMcl): 9co. ETA DEST YjTF(DATEITIr!---):
97. 0-11,4.ER CGYiiMENTS-
51. TMSN *@ 0000/7@iO 52. RON LO@l;
57. VA'@IDVIFD BY/REAS FOR HIGHER PRECEDENCE:
96. ArRr AFT ITINERARY:
OR
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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