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File: 102896_aug96_decls1_0038.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-.03:59 PATIENT FILE 10/20/90
PERSONAL DATA - PRIVACY ACT OF 1974
1. NAME: 18, AUTHOR TTY 030!AO'fi 2. SSAIN-
3@ PRECEDENCE: R
4, STAT: All 5. GRADE! 'Col 6. AGE@ 20Y 7. SEX: M S. 'i4T@. 171 9. READY DATE: 300
l@ ISO: 11. @OR: 12. SPEC CAT: 1
14. REAS DS 15. DATE LAST VISIT@ 5 U.S.C. 552 (b)(6) i6, CLASS- 3A
17. ACCEPT P S: '3. APPTI
. Cray , BURG DATEZ NO
20. APTROV AUTH: 21. CA C/l@
@IN, Ct 22@ VALID: I iv-,LE I Y7
23. MiF ORIG: A51@@o USA DISPE,\ISP.RY DHAHRAN 24. ICAD GRIS: 09-DR
25. NITF DEST: A50'00 FRANKFURT ARMY REG M.ED 26. !CAO DEBT: EDAF
,7. il'cd SPEC 1: 500 28. D'@AG 1: 71783 OLD DISRUPTION OF ANTERIOR CPUCIATE LIGAMEN)
C 2: 30. DIAS '4:
31. @2@ED SPEC 3: 32. D T
@.46 3:
32A. PROCEDURE:
33. SPEC DIET: i%/ 34. IVi
35. 02/'@Pr@: N 36. SU'UT: @4 37. KG TUBE; N 33. RESP: N 39. FOLEY@ N 40. STRYKER: N'
41@ 'NICUBI N f@2. TRACT: iN 43. TMFD:
I N 44. CAST/LOC: N 45. TRAP@H- N 46. @ION: N
71. PT BAG TYPE-. ND 72. PT BAB TAG 73. PT EP@6 WT:
47, S'JPP INFO: 225 MAINTENANCE CO@M@OANY, FT SILL OK REPORTED BY:
SUB AREA J@IRD ******DS***+*
48@ MAX C@NRIE STOPS; Y / 9 49. MAX # RONS: Y / 9 50. ALT REST/MAX 4T: N
53, INPATIENT: Y 54. SPEC PRO@ VA DRUG q',-CBHDL W-i NONE X 55. VA CODE:
56. ADMIN/CVERSEAS:
58@ VITAL SIONS(TEi4P/PLILSE/RESP/BLOOD PRESS): 098@6 1 60 / 18 104 70
@.9. HGB- 60. XCT@ 6i. Am@6@ I DATE TAKEN;
62. NBC: 63. SI/VSI: 64. MEDICATIONS: NONE
65. HISTORY: ACCUTE ACL X 8 l@o'KS LEFT BEFORE RECONSTRUCilVE SURG,
66. ITT PP..YSI WILKINS 67. PF@@ 000 000 0000 68. @IARD@4/PPc@! 000 I 000 000 0000
0000
74, ATTENDANT i%'A.FE 75. STATUS: 76. GRADE2
77. AGE: 79. SEX@ 78A. WT: 79. RELA)IONSH TP TO PATIENT:
60. BAG TYPE: 81. BAG TAG 02. BAG WT:
83. ATTENDANT NAME #2: 84. STATUS: 85. GRADE:
Ob@ AGE: 87. SEX: S7A. WT: 68. RELATIONSHIP TO PATIENT:
89. BAB TYPE: 90. BAG TAG 91. BAG !IT:
92. TRANS ORTG PHONE #t EXT:
93. TRANS D@
,ST PHONE EXT:
1
94@ ETA O.RIG MTF(DATE/Tli'iE): 000 95@ ETA DEST llTF(DATEIIIME); 000
97@ OTHER COF.YiEiNjS:
51. rSN #: 0000/300 52. RON LOCT
57. VALIDATED BY/REAS FOR HIGHER PRECEDENCE: 1
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