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File: 102896_aug96_decls1_0030.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@Ol@2A PATIENT FILE 10/0@9/90
PERSONAL DATA PRIVAP@Y ACT OF 1974
13. A
l@ NAME: 'G. AUTHORITY #: V@OCA017 2. SSANI@ 3. PRECFD-ANCE: R
4. ST.AT- 6. AGE: 3@ly 7. SEX; M 8. 'AT: 196 9. READY DATE: 300
l@. ISO: 11. pa-@': 12, SPEC CAT;
iv 1
'4@ REAS REG U.d.C. 552 (b)(6)
i DS DATE LAST VISIT; 16. CLASS: 3A
17. ACCEPT C@HYS@ JM@RO 19@ APPTISURS DATE: NO
20. APPRO@) ALITH: 21@ CA@NI/TNC: 'L2. VALID@ I I ri',E Y6
L
2@'o FITF ORIG: A5150 USA DISPENSARY Tl@qAP@@RAiNI 24. ICAO ORIST OEDR
25. MTF DEST: A5@130 FRANKFURT ARMY REG MED 26. ICAO DEST: EDAF
27. Vi@@D SPEC 1: tliMU 28. DIAS 1: 49--,90 ASTHMA, UNSPECT;:I. TYPE, STATUS ASTH.@IATICUS NOT MEtx'Tjn c
ED
29. MED SPEC 2: 30@ DIAS 2:
31. rc,D SPEC '@ 3@@. DIAS 3:
32A@ PRO'@ED'u',RE@
33. SPEC Dla'-,i: @NI/ 34. IV:
,5@ 02/LPiM: N 1 7@6. SUCT: N 37. NS TUBE: N 38. RESPI N 39. FOLEY: 40. STRYKER: N
4,. INICUBZ N 42. TRACT@ N 43. IM,'tD: N 44. CAST/LOC: N 45. TRACH: N 46. FION: N
71. PT BA' TYPE-. NB 72@ PT RAG TAB 4: 73. PT BAG WT:
47@ Slj'PP IN..-D: 226 MAIN-I III CORPS FORT SILL, OK REPORTED BY
28 CS@@'
4@ MAX ENRTE STOPS: Y 1 9 49. MAX 0 ROINS; Y 9 50. ALT REST/MAX HT: N
5@ INPATIENIT@ Y '@;4@ SPEC FROG: VA DRUS ALCOHO.- WT NONE X 55, VA CODE:
56. AD[iz'"J/GVERSERS:
59. VIT L STSiN'S@TEMPIPL'Lgc@/R;I:SP/BLOOD PRESS),. 098.0 80 16 12C, 90
,A
i?@ PGBZ 60. hCT: 61. ABS- DATE TAKEN:
62. NBC: 63. SI/VSI@ 64@ MEDICATIONS: PREDNISONE 6@) iMB/DA
.1y, INHALER - 2
PUFFS E- 4 HRS
65. HISTORY: PAT TENT HAS 14 YR HISTORY OF ASTHMA. NOW 14ITH ACUTE SYMPTOMS. CAN
NO-[ BE MAINTAINED IN THIS ENVIRONMENT.
68. WARD#/P'H#: 000 I 000 000 0000
69. REPORIED BY: POTTER 70. PV,#: 000 0000
74.A TcN" LNT NAME #I-. 75. STVUS@ 76. BRADE:
AT YA -
77. AGE: 78. SEX: 76A. WT2 79. RELATIONSHIP TO PATIENT:
90@ BAG TYPE: 81. BAG tAS #z 82. BAG 4T:
81,@ ATTENDANT NAME 42: 84. STATUS; 85. GRADE:
86. AGE: 67. SEXI 97A. 14T: 80. RELATIONSHIP TO PATIENT:
99. BAG TYPE: 90. BAG TAG #t 91. BAG V,'Tg
92. TRANS DRIG PHONE c,XT:
93, TRANS DEBT PHONE EXT:
94. ETA GRIS MTF@DATE/TIr!,E): 000 i 95. ET DEST MTF(DATE/TIME): 000
.A
97@ OTHER COMMENTS:
51. M'.91\1 #: 0000/300 52. RON '@OC:
57. VALIDATED BY/REAS FOR HIGHER PRECEDENCE:
96. AIRCRAFT ITINERARY; I I
t
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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