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File: 092396_aug96_decls14_0011.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
PA-Ic'Nl- FILE i2/29190
PERSONAL DATA - PRIVACY AC7 '9i4
5 U.S.C. 552 (b)(6) 13. A
16. AUTh"u.RITY Oj9AO'z2 2. SSANI! @ 3. PRECEi?'CNCE- R
4z STAI: All 5. GRADE: E05 6, AGE; 32Y 7. S-@X: 8, ,4TI 170 9. READY DATE: 3j9
10. ISO! li@ 1 12, SPEC CAT:
14. 4@-PA.6 R@--G: DE 15. DATE LAST VISIT: 't6. CLASS: 3A
i7. ACCEPT PHYS: Jt"iRO 19. APPT/SURS DATET NO
20. APFROV AUTHE 22. VALID; Y5
L3. MTF ORIG: A5150 USA DISPENSARY DHAHR@l'i '@4@ TOAD riEDi
25. MT DEST: 450-@ F: ANKF" - ARIY Rc@ MP-D 26. l'uAG DEST; E'AF
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27. 1.@,ED SPEC l@ SSR 28, DIAB 1: 3829 UNSPECIFIED 'UTTT'S i@@cDIA
20, rED SPEC 2@ SSR 30@ DIA.FJ 2: 4739 C@'7RnuNi@@ SINIJSITIS, UNSPECIFIED
31, FILED SPEC 3: '2@ DIAG 7',
32A. PROCEDURE;
SPEC DIET: N/ 7 . TV:
@4 ,
3@-. 01@/LP@in N 36. SU@@T-. N BP: 38. Rc@sPt N 39@ FOLEY: t,,' 40,, OTRYKER: il,'
U - 11
41. IN",@@D: N42. TRACI: 43. Iri@D: 44. CA T/LP-'Li N 4@'. TRA@@H: @Ni 46. @ION: N
PT BA' TYPE: NB 72, PT DA@ T 7-1. PT BAB 1,@'T:
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47. SU!lp INFOI 7319 RF.EESOBTANG AFB ITALY P@4T AT @-LT 5
I REPORTED BY SUB-OINRO
,@8. MIX ENRT--@ STN@PS: Y / 9 49, TAX iRO,@NS: Y 9 50,. ALT HT@ N 11
53, INPATIENT: Y 54, SPEC PROS: VA DRUG ALCOHOL 1,@,;T NONE X 55@ VA ,GDE2
,6. ADiIIN/GVERSEAS:
58. VITAL SK,%.L-(TEi@,P/PULSP-/RFSP/B'@O'@.'D PRESS): 098@@) 80 18 12@) 80
59. FIBB: 60, HC-,: 61@ ABC: 1 DATE IAKEN@
62. NBC: 6-,. SI/VS-; 64. @yt'cD!CAi!O.NS! AFRIN P@RN
6@'. HI6T RY@ EAO PAIN' AND POPPING FAR 90@ M'I',D EAD PA'N ON, I' T
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BA'@'Di, P.P-cOi@@'S-FR CTION D@ INNER --A@- NEEDED PER CA7s S@@AN, NEEDS LIN' TERM
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66. ATT @@YS@ PA,i" R 67. PH@: 000 O@10 @')OOO 6& @jARD*!PH#: O@llo li@)O 00@)
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69@ REPORTED PY@ TSBI OGB!i'\,SON 70, PP,#: 000 Oflotl
74. AT E@,'DAI@'T NA,' 75. STATUS: ib. 6RA.DE:
7-,: ALZE@ 16@ S@@@: 78A@ 14T: 79, RELAT'CN@@IP TO @-@AT'ENT!
30@ BAG TYPE: 81. PAC TAG 4@ 8'4. BAB l@T:
6@ ATTENDANT AME #2; 84. STATUS: P@o, E@-A@,
86. Ao@c@@ 87. -,EX: 87A. @@T" SS. RELATIONSHIP PATIENT:
89. RAS TYPel- QC,. P-0.@@ TA.@@ 91. BAB WT!
92. TRANS n@Ri'a PHONC@ -tXTi
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,7. VALIDATE BY/REAS --CR PRECEDENCE:
iI11
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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