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File: 092396_aug96_decls14_0005.txt
Subject: PATIENT FILE
Box ID: BX000482
Document Number: 2
Folder Title: MEDSTAT - SITREPS DEC 90 4 OF 6
Folder Seq #: 8
Unit: ARCENT
Parent Organzation: CENTCOM
FAIJE@,IT @T@_ 11/29190
PERSONAL DATA - PRIVAL@Y ACT OF 1974
5 U.S.C. 552 (b)(6)
17. rOD't A
1. NAt,iEi 18. AU@ ORIT #: 036C)fA(,149 2. SSAN@ 3. PRECEDEN'@E@ R
[H Y
4. 0,TPT: Al' q@. GRADE-. E04 6. AGE: 27Y 7. SEX: 'A S. WT: 166 9. READY DATE: 360
10@, 169@@ 11. PBR-, 12. SPE@ '@AT% I
i4@ REAS REfi. DS 15. DATE LAST VISIT@ 16. CLASS: 3A
17. ACCEPT PHYS: '9. APPT/SURG DATE: NO
20, APPR@3V AUTP@: 21. ',AN'L/IN'@; 22, VALID; TiH Y5
@13. riTF ORICI A51@@o USA DISPENSARY DHAHRAN 24. TR@AO ORIG: OEDR
25. @iTF DEST: A5030 FRAN' cu@RT ARMY @R'cs NED 26. ICAD DEST; EDAF
21-,. NED SPEC 1: SSU 28. DIAG 1: 5942 CALCULUS l@l URETHRA
29. ric@D SPEC 2@ 30. LIIAC 2-.
31. rl--.D SPEC 3: 32, DIAS 3:
@'@A. PROCEDURE:
33. OPEC DIET: @N/ 34. IV:
N -N7. NO TUBE: N 36. RESP: N 39, FOLEY,. N 40. STRYKED:
41. I@NCUB: N 42. TRACT: N 43. TrE@9: N 44. @ S'/LGC: N A . ' ACH: N 46@ rGN4 \I
A .5 @R
71. PT BAG TYPE: NB 72. PT BAG -.AS 73. PT BAS WT@
47@ SLP? INFO: 24 816 CD, FT STEW@A7@i, CA i BUD iviRal/
//FLEET 5//
48. Ili4X ENRTE STO@S: Y / 9 49. j@iAX # R@2NS: Y 9 50. ALT REST/?tAX HT: N
51@. l@4PA7fTENT: Y 54. SPEC P@q'OG: VA DRUG AL,--CL' L tl!T NONE X '5. VA 'LODE:
56. ADiIIN/OVERSEAS@
58. VITAL SIGNE(Tc,M@P/PULS'CIRESP/BLOGD PRESS): 078.0 80 20 "40 / 70
59. HOB: 60. H.CT: bl . AK-.: / DATE TAKE'li
62. t4BC. 67. SI/VSI@ 6'@. MEDICAIIONS: T LEND' 04H PRN
.Y L Q
6@l, HISTORY@ SYMPTOMATIC RIGHT DISTAL URETHRAL CALCULUS. HYPERCAI-CIRIA FROM 8 tv'
n@v-S DEC. POSATHYRDIDECTO@MY. SEND CUT OF AOR FOR S/P AND POSATHYROIDEC-IOrtY.
6b. A'T PHYS; MCDONALD 67. PH#@ 999 999 9999 66. WARD#/PH4@: 999 / 999 999 9999
69. REPORTED BY: SGT ABB'Ull 70. PH#: 999 9999
74. ATTENDANT NAME #I: 75. STATUS: 76. GRADE:
SEX: 78A. @ll: 79. RELATIn@iNSHIP TO PAT TENT:
90. -@ TYPE. St. PAS TA!@2 #t 82, BAG WT-.
B.-3. ATTENDANI NAME #2: 84. STATUS: 85. GRADE:
86. APSE: 87. SEX: 67A. @,T@ 88. RELATIONSHIP TO PATIENT:
B?. BAG T PE: 90. BAG TA13 91, DAG qT@
ly
92, TRANS ORTR@ PHONE EXT:
93. TRANS DEST PHONE EXi:
94. c@1A. OR!6 MTF(DATE/TIkIE): 000 95. ---IA DEST MiF(DATC@/T'riE): 000
97. OTHER COMMENTS.
51, MSN #! 0000/360 52. RON LOC:
57@ VALIDATED BY/PEAS FOR H.TCPR@R PRECEDENCE: I
9b@ATRC,@AF- ITINERARY: f
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Document 30 f:/Week-32/BX000482/MEDSTAT - SITREPS DEC 90 4 OF 6/patient file:09069614064231
Control Fields 17
File Room = aug96_declassified
File Cabinet = Week-32
Box ID = BX000482
Unit = ARCENT
Parent Organization = CENTCOM
Folder Title = MEDSTAT - SITREPS DEC 90 4 OF 6
Folder Seq # = 8
Subject = PATIENT FILE
Document Seq # = 31
Document Date =
Scan Date = 14-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 = 06-SEP-1996