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File: 091896_aug96_decls27_0001.txt
Subject: MEDICAL SURVEILLANCE REPORT 19 JUL 91
Box ID: BX005154
Document Number: 5
Folder Title: 212TH MED DET OA MEDICAL SURVEILLANCE REPORTS 05 AUG - 05 SEP 91
Folder Seq #: 74
Unit: 22D SUPCOM
Parent Organzation: ARCENT
MEDICAL SURVELLANCE REPORT Pa.@e 11
REPORT AS OF -------- t .-I'lE) DATE:LqL(g I
NAME OF UNIT/CLINJC:@
POPULATION SI-E:
----------------------------------
MALE FEMALE 15
T
PATIENTS SEEN: ---- -----------
REFERRED To HOSPITAL: -
PATIENTS REFERRED T6 CISPITAL: ----------
GYN p f
FOLLOW-UF VISITS: -----------------------------
r,(.DLD INJURY ----------
DIARRHEAL DISEASE-----@ -----
l'-'INC)r-OLDC-'CAL PROBLEMS -------
HEAT INJURY -----------------
(DPTHALMOLOC,117A[, PROBLEMS -----
INFECTION -----------------
INJURY ----- :5 ------- -----
ORTHOPEDIC ---- ------------
PREGNANCY --------------------
PSYC;HIATRIC CONDITIONS -------
SEXUALLY TRANSMITTED DISEASE:
U MALE -------------------
:t FEMALE ---
# CONTACT-S--R@ACH D/OR TREATED -----------------
ST@IN CONDITIONS
TRAUMA ........ --------
UPPER RESPIRATORY
VAC,INITIS -------------
ALL DTHER CONDITIONS --- ------
2. REPORTABLE DISEASE:
A. VIRAL HEPATITIS L. MENINGOCOCCAL DIS ) --------
B. HEAT STROKE M. PLAGUE --------------------
,:. ANTHRAX -------- N. RABIES -----------
D. BOTULISM -------------- 0. Q FEVER -------- --------
ISTOSOMIASTS ----------
F. CHOLERA ...... .......
i-iEMk-.iiAH-AClt- FFVVR ----
H. DENGUE FEVER --- 4@ ----- Q. SPIROCHAETAL Di -------
1. fiELMINTHIC INF. @ ------ R. TRACHOMA ------ -------
J. LEISHMANTASIS _@ ------- - S. TOXOPLASMOSIS _ -------
i'. MALARIA ......./--------- T. TYPHOID ------- -------
U. TYPHUS -------- -------
V. OTHER (EFECIFY) -------
PROBLEM INDENTIFICATION:
CORRECTIVE ACTIONS: Appendix B
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Document 3 f:/Week-34/BX005154/212TH MED DET OA MEDICAL SURVEILLANCE REPORTS 05 AUG - 05 SEP 91/medical surveillance report 19 jul 91:09139616140762
Control Fields 17
File Room = aug96_declassified
File Cabinet = Week-34
Box ID = BX005154
Unit = 22D SUPCOM
Parent Organization = ARCENT
Folder Title = 212TH MED DET OA MEDICAL SURVEILLANCE REPORTS 05 AUG - 05 SEP 91
Folder Seq # = 74
Subject = MEDICAL SURVEILLANCE REPORT 19 JUL 91
Document Seq # = 62
Document Date =
Scan Date = 30-AUG-1996
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 = 13-SEP-1996