Document Page: First | Prev | Next | All | Image | This Release | Search
File: 102896_aug96_decls4_0024.txt
Subject: PATIENT FILE
Box ID: BX000482
Unit: ARCENT
Parent Organization: CENTCOM
Folder Title: MEDSTAT - SITREPS OCT 90 3 OF 4
Folder SEQ #: 16
Document Number: 11
Cj3:57:03 PATIENT FILE 10130/90
PERSONAL DATA - PRIVACY ALi Or' 1974
5 U.S.C. 552 (b)(6)
13, iyiODE: A
12 NAME: 18. AUTF@ORITY #- F,02AOA,3 2= SSPN: 3@
4@ SI-Aii All S. BRADE: c@06 6. @APP- 32Y 7. SEX: S. 1.4T@ 140 9. READY DATE: 302
'O, ISO: ,I. p I'@ 1 12. SPEC ' T:
L. . C,,q OA
14, R@,AS Rc@G@ DS 15. DAIE LAST VT ST T: 16. CLASS: 2B
i7@ ACCEPT PHY'--: J,'IRU 19. APPT/SIJR'o DATE: NO
20. APPROV AUT'n': 21, CANC/INC: 22. VALID: BIM Yi
23@ VITF GRIG- A5!50 IJSA DISPENSARY DHAHRAN 24. IP@RA ORIS-. GEDR
25. MTF DEST@ A5030 FRANKr'LIRT ARMY REG MED 26. ICAO DEST: EDA@
27. @'@ED SPEC i: riMS 28@ DIAS ii 7690 ABDOMINAL PAIN
29. @.ED SPEC @@ SSU 30. DIAS 2: 7690 ABDOMINAL PAIN
31, VIED &@@-I 3z 32, DIAG
32A. '@ROCEDliRul:
33. SPEC D!Ei: N/ 34. IV:
37o. 02/LPMt N' 36. SUCT@ r@' 37@ NG TUBc@t hi 38. RESP: N, 39. FOLEY; N' 4(i. STRYKER: N
N 4@@, TRACTI N 43. l@.ED: N 44. CASi/LDC: i\l 43. TRACH: N 46. MON: N
71. PT BAB TYPE- NB 72. PT BAB TAG 7'. PT BAG @IT:
47@ SUPP INFO: 2tTH ORD 'uO@ HUNTER ARMY AIRFIELD, OA REPORTED BY
5 ty@@ASH
49. mAX PNIRTE STOPS; Y 9 49. @',AX # RONS: Y 9 50. ALT REST/,YiAX HI: N' f
53. INPATIENT,, Y 54. SPEC PROB: VA DRUL ALCOHOL WT kloti@ x 55. VA CODE:
c
,6. ADiitqN/DVERSEAS:
58@ VITAL SIGNS(TEriP/PULSE/PrSPIBLDOD PRESS)-. 098.2 54 iS 06 58
59. HGB: 6(i@ PCT: 61. ADG: DATE TAXEN;
62. 'ABC: 63, SI/VS!; 64. ViEDIP,ATTOINSt SEPTRA @DEL STRENGTH) OD/TYLENO! #3
TAB 93HRE PPN PAIN
65. HTSTORYT 'rT C/O LOWER ABDOMINAL PAIN; NORMAL IJRINALYSIS, IVP, A@N' CBC'S. LP.R
u
BE BLADDER CAPACITY - NEEDS LIROLOGI@@ EVAL COMPLETED AND ADDITIONAL %iORK,-LIP OF
ABDOMINAL rnATN. **ATTPNDI,\9 PHYSICIAN 19 A UROL13GIST**
66@ A,-,'T PHYS: ti.C. DUPONT 67. PH4: 000 000 0000 68. WARD#/PH#,. 000 / 000 000 0000
69. @;-DtjR'ED BY-, DENTON 70, PH#: 000 0000
74. ATTENDANT NAME #'L; 75. STATUrt-) : 76. GRADE:
77. AGE: 78, SEX: 78A. WT@ 79@ RELATIONSHIP To PATIENT:
80. BAG TYP'ct 61. BAB ',AG tb@ 82, BAG WT;
. ATTENDANT NAME #2t 84. STATUS: 85. CRADE@
66. ACE: 87, SEX: 87A. WT: 88. RELATIONSHIP TO PATIENTI
89. BAB TYPE@ 90. BAG TAG 91. BAG WT:
92. TRANS ORIG PHONE O.: cAT:
93@ TRANS DEST PHONE EXTI
94. ETA ORIG iN!-iF(DATE/TIME); 000 95. ETA DEST r!TF(DATc@/TIMc-); 000
97. OTHER COMMENTS:
51. @',SN 0: 00001302 @,2. RON LOC:
57. VALIDATED BY/REAS FOR HIGHER PRECEDENCE:
96, AIRCRAFT ITT\ERARY@
Document Page: First | Prev | Next | All | Image | This Release | Search
Document 31 f:/Week-32/BX000482/MEDSTAT - SITREPS OCT 90 3 OF 4/patient file:10019616503620
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
Document Seq # = 11
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