Document Page: First | Prev | Next | All | Image | This Release | Search
File: 102896_aug96_decls4_0026.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
07 -.57:36 PATIENT -TL-t 10/30/90
PERSONAL DATA - @DRIVA.CY ACT OF 1974
5 U.S.C. 552 (b)(6)
13. ilODE: A
16. AUTHORITY 0301AO'@@@ 2. SBAN-. 3. PRECEDENCE: P,
4@ STATI All 5, GRADEI E03 6. AGE@ 23Y 7. SE.X@ 0, S. .4T: 140 9. READY DATE: 301
10@ ISO: 11. POD: 12@ SPEC CAT:
14@ REAS RES: DS 15@ DATE LAST VISIT: 16. CLASS% 2D
17@ ACCEPT PHY@ 19. APPT/SUR'u DATE: NO
20. APPROV AUTH: '-)I. CAN'@/INC: 22@ VALID: JRL I Y2
I ',4.TF OR IC.
P@5150 USA DISPENSARY DHAHRAN 24. TCAO DRIG: GEDR
25@ MTF DEST: A@1030 FRANKFURT ARMY REG M@-D '46. ICAD DEST: EDAF
47@ FJED SPEC 1; SOO 28@ DTAG I-. 7'73 3THE@ AND UNSPECIFIED DERANSE:ME,%'T OF MEDIAL MENISCUS
29. @ED SPEC O@@ 0. DIAS 2;
DC
SPC 3: 32@ DIAS 3:
32A. PROEP-D'u',@c@i
37,@ SPEC DIET: @N/ @4. IV:
35. 02/LP,@i: N, 36@ SUCT- t@' 37. NS TUBE: N 38. RESP: N' 39. FOLEY: N 40. STRYKER: N
41. 'LiNiCUB; IN 42. TRACT: N 43. IMED@ N 44. CAST/LOC: N 45, -IRACH! 46. 'eON: N
71. PT BAB TYPEZ NIB 72. PT BAG TAG 73. PT DAB t@T;
47: SUPP '@@NFO@ FT SILL 0.@ 28 CSH
48. MAX ENRTE S7iOP6t Y / 9 #,9. VAX # RMI : Y / 9 50. IYLT REST/MAX HT: N
5-l' , INP.AT !EN'T.
.. Y54, SPEC PROG: VA DRUG ALCOHOL WT NONE X 5@@@ VA CODE:
56. Ar@MIN/GVc@RSEA@
VT TAL SIGINS(@ MP/PU@CF-/RESP/BLDCD PRc 6): 098.2 70 1 16 '20 1 78
IiE Is 1
59@ L,'GB@ 60. HOT: 61. ABS, I I / DATE TAKEN:
62. lilBC-@ 6'@. SI/VSI! 64. MEDICATIONS NONE
eQ. .4ISTORY-. TWIS7iED L KNEE PLAYING FOOTBALL ?- DAYS AGO UNABLE TO @@'ALK,
NO CA@ST.
66. AT' P.HYS: BROPHY 67. Ph*: 000 000 0000 68, WARD#/PH@.: 000 000 000 0000
70. PH#: 000 0000
74. ATTENDANT NAME #1@ 75. STATUS: 76. GRADE;
77. AGE: 78. SEX: 78A. WT: 79@ RELATIONSHIP TO PATIENT:
90. BAB TYPE: 'I. p G TAG 82. BAB WTz
o@ -A
83. ATTE@DAN, NAME 42: 84. STPFtUSt 8,@. GRADE:
86. AGE: 87. SEX: 67A. ',4T: 88. RELATIONSHIP TO PATIENT:
89. Prc TYPE. 90. BAB TAG 91. BAG WT!
92. TRANS CRIS PHONE t; CX':
g-,. TANS DEST PHONE N
I PI
94. ETA U-RIG MTF(DAi@--ITL@iE): 000 95. ETA DEST ViTr@(DATE/TIME); 000 1
97@ OT @COMMENTS:
, PER
@,l@ IMSN 4: 'VOOO/301 52@ RON LOC-
,@7@ VALIDAT D BY/R@ SRIG" R PR@
.E @A O@, C-D, a
9'0. AIRCRAFT TTI@\11-RARYiI I I
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