56 TAC HOSPITAL ATH 12 DEC 90

File: 092396_aug96_decls19_0003.txt
Page: 0003
Total Pages: 7

Subject: 56 TAC HOSPITAL ATH 12 DEC 90                                   

Box  ID: BX000482

Document Number:         13

Folder Title: MEDSTAT - SITREPS  DEC 90  6 OF 6                                                               

Folder Seq #:         10

Unit: ARCENT      

Parent Organzation: CENTCOM     





                                                                                                              ..,UR


                                                                                I
                                                                               WARD                            REGISTER NO.

                                                                                                               60
                                                                               SERNilcr                       PHYSICIAN



                                                                  REASON FOR REPORT
                    COMMUNICABLE DISEASE                                           VERY SERIOUSLY ILL PATIENT
                    INJURY INCURRED AFTER ADMISSION                                SERIOUSLY ILL PATIENT
                    ANTICIPATED MEDICAL BOARD/PHYSICAL EVALUATION                  INCAPACITATING ILLNESS OR INJURY
                    BOARD ACTION                                                   REMOVE PATIENT FROM VERY SERIOUSLY ILL. SERIOUSLY
                                                                                   ILL OR INCAPACITATING IUUMESS OR INJURY LISTS
                     PROLONGED @SPITALIZATION(90 d&YOOriOngOd
                                                                                   REQUEST MEDICAL   REco mFir-,
                   I A DEATH                                                   I   OTHER (SPOCITY in @&A.)
                Ill. DIAGNOSES



                IV.                                           PROGNOSIS/NEXT OF KIM DATA
                                                                                                              NOT ASSURED. FURTHER
                         RECOVERYIS       ILEXP,      ECTED                        NOT EXPECTED               OBSERVATION NECESSARY

                 PRESENCE OF RELATIVE$ D"I"KD                                  NEXT OF KIN IS AT BEDSIDE


                 CLEARANCE My CHIEF OP SK"ICK                                  NEXT OF KIN HAS 899H NOTIFIED
                 DATE                          NAME OF PHYSICIAN                      -7NATURK
                         t @ -C)o                  /@i LA)
                V.                        ACTION BY REGISTkAR/ADMINIS-eRATIVE OFFICER OF THE DAY ddYERY
                                   SERIOUSLY ILL, SERIOUSLY ILL, INCAPACITATING ILLNESS OR INJURY, AND DEATH CASES
                                   ACTION                   DATE      HOUR                     ACTION                     DATE      HOUR
                                                                               HOSPITAL PERSONNEL NOTIFIED
                 RSPORT RECEIVED                                               (Specify blow)

                 BASIK PERSONNEL REPONMOLE FOR
                 CASUALTY NOTIFICATION ADVISED

                 OTHER BASS PERSONNEL NOTIFIED
                 (Specify b*io.)














                  DATE                         NAMC OF R 961 STR AR/ ADMINI STR ATI VE 0 FFIC MR  SIGNATURIC
                                              I THE DAY                                           I
                                                 'Ci ri       C, -Jo r c@c,
                      FOR          PREVIOUS EDITION WILL BE
                 AF APR M75

Document 7 f:/Week-32/BX000482/MEDSTAT - SITREPS DEC 90 6 OF 6/56 tac hospital ath 12 dec 90:09069614065336
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 6 OF 6
Folder Seq # = 10
Subject = 56 TAC HOSPITAL ATH 12 DEC 90
Document Seq # = 36
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