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File: 092396_aug96_decls14_0010.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
PATIENT FILE 12/0@9/00
PP-RSFIAAL DATA - FRIVACY ACT O.- iQ74
5 U.S.C. 552 (b)(6) 13. @,[!D-: A
NAIAE: 16. AUTHORITY #: 0359A,109 2. SSA@N: 3. PRECEDENCE: R
4. STAT: All 5. BRADE! E04 6. ACE: 21Y 7. Sc,X; M S. @,'T: '51@ 9. READY DATE: -@59
10@ !SO: 11. POR: 12. SPEC CAI:
14. @P-PAS RES: DS 15. DATE LAST VISIT: 16. CLASS: 3A
17. ACCEPT PPYS: 19. A@PT/SURG DATE- NO
20. APPROV AUTH: 21. CANCIINC4 22. VALID: IJH Y4
2-N@ t,'jTF ORI@@: A5'50 '-ISA DISPENSARY DHAHRAN 24. ICAD 0010@ CED.R
25. mTF DEST: AJO40 2ND G@il HOSP I-ANDSTLHI- 26. "LAO DP-ST: C,DAR
27. V@ED SPEC 1: SOO 28, D'@A@, 1: 71100 PYOCETIT C ARTHRITIS, SITE UNSPECIFIED
29@ i@,ED BP-tc 2: 30, DIAG 2:
,I. t!ED SPEC 3: 32. DTAG 3:
32A. PROC'cDUR,:
3. SPEC D T'T: NI TV:
IC -4. 1
39, FOLEY@ N 140. STRYKER: 'N
41. INCUB: N 42. TRAC": N 43. Il@,EDi N 44. CASTILO.P: N 45. TRAC.,@; N 46. Mni N
71. PT BAB TYPE: NB 72, PT BAG TAG 73. PT BAG WT:
47. SUPP T T
@@NIFO: 75iH BDc@, A QA:TERY, 5/iS FORT BILL OK //SLID jiMRO//
//FLEET 5//
48@ iyiAX C,NRTE STOPS: Y 9 49@ riAX # RONS; Y / 9 50, ALT R'CST/,,',IAX HT! N
57@. !NPATTEi%T: Y @@4. SPEC PROB: VA DRI.16 ALCOHO' @'T NONE X 55. VA CODE:
56@ ADIIK'/GVE@RSEAS,
@E. VITAL SiGi\S(TEMP/PULSE/RESP/BL'UOD PRESS): 098@6 70@ /16 120 I 60
59. H@@D: 60. HCT: 61. ABPO: I DAT TAKEN;
.E
62. WB": 63. ST/VST2 64. iMn'CATIONS: CTPRO-LORIN 750,,'!G ETD, vnTRI" BOCM13
BID.
65. HISTORY: SEPTIC ARTHRITIS R 'N'N@@E@ 29 @40V 90 SIP !)\@'D. NOW WI FIBRD AR-IH.ROSIS
HAD NIC@N@-@-PECIFIC iRAUriA Tl R KNEE X l@j"
66. ATI PHYS: TERNES 67, Pu4; 000 000 0000 68. WARI.I/PH#: 000 / f)O(l 000 0000
69@ REPORTED BY: HERREMANS 70. PH,#: 000 00@O
74@ ATiEiNDANT NArl'-c #It 7@@@ STATUS; 76. GRADE:
7GE .0
X: 78A..@,T: 79. RELAT70NSHIP PATIENT:
S'V. BAB TYPE: 81. BAB TAG 82. BAB @4T;
83. ATTENDANT NA@IE 4@2: 84. STATUS: S5. GRADE:
86@ AGE: 7. SEX: 97A. WTi 88. R@-LA I iu PATIENT:
89. BAB TYPE: 90. BAB TAG 91. 'DAB WT:
92. TRANS D@R'@6 PHONE 4: EXT:
?@-1. TRANS DEST PHONE EXT:
94. CT CRIG MT (DATE/TIM;:)i 000 1 95. cTA DEST MT (@,A E/TI@t,,c): OOA
@,A IF. F .,T
97. 'OTHER COi@-.@,ENTS:
-1
D@. 1151%, 4@ O'vOo/y@9 @,2. RON LOC:
57. VALIDATED BY/REAS FC@P, HlCqED PRECEDENCE:
96, A-@'Rr,RAF- ITT%' RA V.
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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