PATIENT FILE 29 OCT 90

File: 102896_aug96_decls1_0032.txt
Page: 0032
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



              07:01:@@7                                               FAII-@INT F     -I LE                                      10/29/90
                                                          PERSONAL DATA - PRIVACY AmC] OF '974



                                                                                                                            13.  riodr: A
                                                              18. AUTHO
           1. NAME:                                                      @IITY #: 03(]OAOI9          BSA                    3.   PRECEDENCE: R
           4. STAT;                                           6. AGE:    19Y          7. SEX: iM         B. WT:    172      9.   READY DATE; 300
           10. 160:               11. POR:                                                                                  12.  SPEC CAT:
           14. @REAS RES: m'S     15. DATE LAST VISIT:            5 U.S.C. 552 (b)(6)                                       16.  CLASS: 3A
           17. ACCEPT PHYS:                                                                                                 19@  APPT/cURS DATE: NO
           20. APPROV AU-[H:                                                          2'. @@ANCIINC:                        22.  VALID:                 M.LE   Y6
           2,@. FITF ORI@      A5150 USA DISPENSARY DPA4RAN                                                                 24.  IR@PIO DRIG:   OEDR
           25. FITF DEST: A5030   FRANKFURI ARMY RED      @',Iic,D                                                          26.  ICAO DEST:     EDAF
           27@ @'@ED SPEC 1: 600  20, DIAS 1: 71597       OSTEGARTHROSIS, UNSPECIFIED IWVOLVING ANKLE AND R:GDT
           L9. @.ED SPEC 2@       30@ DIAS 2:
           31@ MP-D SPEC 3:       32@ DIAG 3:
           32A. PROCEDURE@
           - EC @ ,                                                                   34. IV:
           N3. SPc D TET@      N/
UBE: N             38. RESP: N                     39. FOLEY:        N       40. STRYKER: N
           41@ 'NCUB:          N  42. TRACT: N            43. IMED: N'                44. CAST/I@O'L: N 1             45. TRACH:        N       46. @in@N: N
           71. PT BAG T Pr: ND                            72. PT BAG TAB      #i                                      73. PT BAG WT:
                               @y -
           47@ SUPP INFO: B CO    20TH ENSR 101 ABi%l FT      CAMPBELL, KY                                   REPORTED BY
           .'B CSH
           48@ MAX ENRIE STOPS: Y / 9                     49. YAX 4@ RONS:            Y/ 9                            50, ALT RES@t/jyiAX HT.- N 1
           5@'. INPATIENT: Y      54. SPEC PRGB-          VA  DRUG       ALCOHOL      @'T    NONE X                   55. VA CODE:
           ,6. ADML@IIOVERSEAS:
           58. VITAL SIGIS@TEriP/PULSE/RESP/BiloOD PRESS): 098@8                      60 116  I--,O      66
           59. HOB:               60. HOT:                61. ABS:                                       DATE TAKEN:
           62. 1,4BC;             63. S'/VSI:             64. ric@DICATICi\'S: NONE




           65@ HISTORY: UN14BLE   TO RUN S@@ICE SEVERE FX OF LEFT ANIKLE IN JAN 90. COMPLAINS OF
           PAli\' IN JOINT








           66. ATT PHYSI ALC@XPIIERO             67. PH#; 000 000 0000                               68. WARD#IPH#: 000          000 000 0000
           69@ REPO@RTED BY: POTIER                                                                  70@ PH@4: 000 0000
           74, ATTENDANT %IAME #I:                                                                   75, STATUS;                            76. GRADE:
           77. ACE!                              78. SEX@                78A. WT;                    79, RPIATIONSHIP Tr,' PATIENT@
           80. BAG TYPE;                         81. BAG TAG 1:                                      82. BAG WT:
                        84. STATUS:                           85. GRADE:
           26. ATOE-                             87@ SEX:                97A. WT:                    68. RELATIONSHIP TO PATTENTI
           89@ GAS TYPE;                         90. DAG TAG t,:                                     71. BAG 14T:
           92. TRANS CRIG PHONE                           P-XT,
           9'@. TRANS DEST PHONE                          EXT:
           94. c@A ORIG        MTF(DATE/TIME): 000                                                   95. ETA DEST ?ITF(DATE/TI?IE): 000
           91. OTHER CO.MV@'cNTS@



           51@ imSN #: 0000/300                                                                     52. RON LOC:
           57. VALIDATED BY/REA.9 FOR HIGHER PRECEDENCE:
           96@ AIRCRAFT ITINERARY:         I

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