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File: 102896_aug96_decls1_0033.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@02:22 **** PATIENT FILE **** 10/29/9.)
P:@@RSn@NA'- DATA - PRIVACY ACT OF 1974
13. indc': A
'8@ AUTHOR ITY #: 030OA018 2. SSAN' 3. PRECEDENCE. R
4. STAT: All 5@ GRADE: EA@2 6. AGE: 22Y 0
7. SCX: 9. READY DAT@-: @o
10, lsn.; 11. POD: 12. SPEC CAI:
14, REAS REG: DS 15. DATE LAST VISIT: 16. CLASS: 3A
17@ ACCEPT PHYS: JrjRD 5 U.S.C. 552 (b)(6) 19. APPT/SURG DATE: NO
20@ APPIROV AUTH. 21. '@ANC/IN.C: 22. VALID: MLE Y6
23. t@,TF ORIG: A5150 USA. DISPENSARY DHAHRAN 24. ICAD ORIG: OEDR
25. MTF DEST: @-5070 IJSAFR,@IC WIESBADEN GE 2t. ICAD v'EST@ EDAF
2'. @MED SPEC 1: I'iM'd 28@ DIAS l@ 49390 ASTF..rA, UNSPECIFIED TYPE, STATUS ASTP.VIATICES NOT ri@CKITIONED
.9. @.-'-D SPEC 2; 30. DIAS 2@
.@l@ riED SPEC 3: 32. DIAS 3:
3'4A. PROCEDURE:
33@ SPEC Dic@T: iN/ --,4, TV@
i@ N 36. SLICT- t4 37@ NS TUBE: N 38. RESP: N '09. FOLEYT N' 40. STRYKER: N'
41, TN," B: N 42. TRAP@TI N' 43.I
@ @ii @@NED: N 44. CAST/LOC: N 45. TRA'@H: N 46. VON: N
7i. PT SAG TYPE. ND 72. PT BAG TAG 7'0. PT RAS WT:
47. SUPP INFO: FHB 1141 FA, 24 li%,F DIV, FT. STEWART, GA REPORTED BY
28 rIsPi
43. @.AX ENRTE STOPS: Y 9 49. TAX # RONS: Y 9 50. ALT REST/IIAX PT:
53. INPATIENT. Y 54. OPEC PRO@ VA DRUG ALCOHOL '4T NONE X @15. VA CODE:
56@ ADIIN/@nVERSEAS:
58. VITAL SIONS(TEMP/OULSE/RESP/BLOOD PR--'SS): 098.0 80 24 / 136 66
59. HCB: 60. PCT: 61. ABB: DATE TAKEN:
62. 14BC: 63. SI/VSI: 64. MEDICATIONS: PREVENTOC IN.HAI R 2 PUFFS 9 4 HRE
@E
PREDN'ISONE 60 Mzr/DAY
65. HISTORY: HISTORY OF ASTH@'IA SINCE CHILDHOOD. BEGAN HAVING COUGHING AND
WHEEZING SOON AFTER ARRIVAL IN THEATRE. HAS HAD SEVERAL SEVERE ATTACKS.
NEEDS TO DE 01-IT OF AOR
66. ATT PLI@YS; MAJ 'GARDNER 67, PHI: 000 'VOO 0000 68. WARD#/PH#: 000 / 000 000 0000
69@ REPORTED BY: POTTER 70. P,4#; 000 0000
74, ATTENDANT NA@miE #I: 75. STATUS: 76. GRADEI
78. SEX@@ 76A. tk]T: 79@ RELATIOi%THIP TO PATIENT:
80. BAG TYP--@ 91. BAG TAG 4: 82. BAG WT:
83@ ATTENDANT i%faric, #2: 84. STATUS: 85. GRADE:
86. AGE: 87. SEX. 87A. WT@ 98. RELATIONSHIP TO PAT IENT:
89. BAG TYPE: 90. BAG TAB 4: 91. BAG WT:
92. T ANS ORIC PHONE EXT@
@R
93, TRANS DEST PHONE #z EXT:
94@ ETA ORTLG @ITF(DATE/Ti@,E)t 000 9co. ETA DEST i'@fTF(DATE/TIME): 000
9'. OTHER '@OM',I:NITS:
51. i@SN #: 0000/300 52, RON Ln@c;
57. VALIDATED BY/REAS FOR HIGHER PRECEDE.\'C;-:@
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