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File: 092396_aug96_decls14_0007.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
PAT Tf: T FIL@ '2/@ '90
-91
PERSONAL nATA - PRTVAf' ACT OF '974
oqv @c 90
5 U.S.C. 552 (b)(6) 13@ riODP-z A
1. N!Ar;Et 'S. AUTHORITY 4: 07,@9AO'8 SSAN: 71. PRPCEDEN@,ET R
4. STAT: All 5. GRADE: E06 6@ AGE: 29Y 7. SEX: M 8, 41@ 160 9. READY DATE@ 359
I,). ISO; 11. POR: i2. SPEC @IAT:
14. REAS REG: DS 15, DATF- L49T VISIT: 16. CLASS: 2B
17. ACCEPT PHYS: JMRO 19. A.PPT/SURS DATE@ NO
20, APPROV AJTH: 2i. CA@L.\ICIIN@C: 22. VALIDI I CW@4 Y5
23. r@@T ORIC: A5151@ USA DISPENSARY DHAHRAN 24. IP.AD [[RIG: OP-DR
,F
GEN HOSP LAN'VSTUHI 26, !'AD DEST: EDAR
5. M7tF DC T @o
27, NED SPEC it BEN 26. DIAS 1; 72210 INTERVERTEBHP.L DISC DISPLAC@,r@.ENT Wo MYELOPATHY, LUMBAR
29. @YED SPEC 2: SOOL 30. DIAG 2: 72210 INTE@RVERTEDRAL DISC DISPLACEMENT 140 @YEi-OPAT Y, I MBAR
IH @u
31. MED SPEC 3: 32, DIAG
7.2A. PROCEDURE;
3@ SPEC Dic-T@ N/ 34. IV:
5. 02/1@PM: N 36. SUL-T: N 37@ NS TUDE@ N' 38. RESP: N' 39. FOLEY- N 40. STRYKER: %I
11
41. IN".B: @l 42. TRACI: N 43. I@IED; N 44. '@AST/LOCi N 45. IRACH: N 46, VON: N
7'@ PT RAS TYPE: NB 72, PT RAS TAG 73. PT BAG WT-.
47, SLIE'P INFO@ REPORTED BY 17,@RD/PT FROM 85 'EVAC
48. m.AX ENRTE STOP@ Y 1 9 49. MAX # RONS: Y / 9 50. ALT REST/r.AX HT: N
517. INPATIENT: Y 54. SPEC PRO': VA DRUG ALI-'POHOL T NONE X 55. VA CODEI
56, ADViIN/OVERSEAS@
58. VTIAL SIGNS(TP-MPIPI@'i'SE/RESP"B"OOD PRESS)I 096.6 60@ / i8 / 104 70
59, uGBt 60. H.CT: 61. AEG: I DATE TAKENI
63. SI/VSii 64. MEDICATIONS: MOTRIN, 600 ils TID PO; TYLENOL PRN
6'@. P.ISTORYT 29YOri @ITYH LEFT SCIATICA ABSENT AJ -, 4/5 GASTRASAI ENS @4EAMIESS ON'
EXAM. REQUIRES PROLONGED BED REST. NEEDS PtYELOGRAM/SURGERY.
66. ATT PHYS: LEECH @@7. PH#: 000 000 0000 68. WARD#/PF@4: 001) i OCIO OCIO 0000
69. R@-pl'-3R,ED BY: SGT @@.AR' A@4T 70. PH#: 000 OOCIO
74. ATTENDPI@@IT t4AMc 7@.@ STA.:,US: 76. GRADE:
77. AG 78. SEX: 78A. WT: 79@ RELATIONSHIP TO PATIENT:
80, BAD TYPE: 81. BAG iA6 BAG WT;
go@. ATTENDANT NAME #2: 'o4. SiATbS: 89. GRADE!
86. AGET 67. SEX: 87A. @IT: BB. RELATIONSHIP TO PATIENT:
89. BAG TYPE: 90. BAB TAG ?I. BAB WT:
TRANS '1@RI6 PHONE EXT:
I
TRA!NS DEST PHONE EXT:
@3 ,
94. ETA GRIG ilTF(DA.-IE/Ti@IE): 9ci. ETA DEST iATF(DATE/Tltv!E):
97. OTHER COM.MEN'@St
N LOC:
@7, VALIDATED BY/REAS FOR P.164ER PRECEDENCE:
96. AIRCRAFT ITINERARY: LTBI, / EDAR I It I
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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