Document Page: First | Prev | Next | All | Image | This Release | Search
File: 092396_aug96_decls28_0001.txt
Subject: PATIENT FILE
Box ID: BX000482
Document Number: 1
Folder Title: MEDSTAT - SITREPS DEC 90 4 OF 6
Folder Seq #: 8
Unit: ARCENT
Parent Organzation: CENTCOM
Cl@_:j :24 PA,-, IE@,'T FLE 12 !'-?9/90
C ELINAI DATA PRIVACY
PER
4C OF '974
5 U.S.C. 552 (b)(6)
I'@. MOD,'I A
3. PRECEDENCE: R
18. AUTHOR! I y '@.t 0359AOi7 2@ SSP.N:@
4. STA.-i. Al' 5. C@OADt-i @c@)6 6. AGE. 4@jY 7. F@X! ill S. WT.- 2i2 9. READY DAi:: 359
11. FOR: 12@ SPEC 'uATt
14. R7=AS 'REG@ DS 15. DATE 'LAST 111SIT: 16. CLASS: 3A
'7. ACCEPT PHYS; u'@'IPO l@. APOT/SURG DATE; N,'Ll
@-)O. AP@@,,iGV AUTH: 21. CA@4'@U/INC; 22. VALID: RINS. I YS
A- -DP,
2'@. t-1-7r RRI@ .4@1150 USA D'Z'. ER,'SADY D,9A.4.RA@l 24. I.,- n op,18; or:
2i@ M'LF DEST; 4jO4O 2@D GEN HOSP LA,@liDSTLIP.L 26. ICAO DEST: EDAR
21. riED SPEC 1: @!@c 'IS. DIAS 1: 4149 CHRONIC ISCHc@i4ilC HEART DISEAF-, UNSPECIFIED
29. M-tD SPEC 2, SSP@A 30. DIAS 2: 4149 CHRONIC ISCPEMIC HEART DIS-,ASE, liiN--iPEr@IPI-tD
31. @4'@ED c-zpg-:c 3! APC 32@ DIAS 3i 4149 CHRONIC !SCHEMI';-, HFA@RT DI-- ASEI "NISP@ lr7lED
"E -Cl.
OROLcDUREi
3.7. SPEC DIET: Y/NON-'- STATED 34, !V:
35. 02/LPi@,'.@ N@ 36 PT: N 37. NS TUBE: KI @38. RESP, k,, 39, FIJLEY, N 40. STR@@KER: t4
41. N 42. IRACT@ il' 43@ IMED: N 44. CAqT/@'-00: i%' f 45. TRACH: iN 46. MBjN4: N
71, PT BAB YPE: 72. PT BAG TAB ff: 771. PT BAB t4T:
47, SUPP 1,N@0, IS--,RD @IATNT 43nD SLIPY SP REPORTED BY
44TP@, riED/471H. CSH
48. i@iAX ENRTT- STOPS. Y / 9 49. MAX 4@ R@nN@, Y 1 9 n. ALT RZST/MAX hT. N 1
VA 'CODE:
56. ADrIN/OVERSEAS!
56. VITAL SIGiNS(TEKF/PULSE/RESP/BLOOD @RPSS): 097.0 1 69 /16 i26 f 59
59, P.GB: 60. hCT: 61, ABB: 'I DATE TA EN:
62. WBC. 63, SI/VSI: 64. VERAPA,'IIC S.,R. PO OD/ELAI;A -%2o@YiSILD
PID BID/1-OVENSTANITON' 2GI.NGS BID
6 WIT
,5. HIS' RYt SIX-VESSE', C,A.V,A.C.; REQUIRES VAL AT FACILITY 14 ANGIOPLASTY
, la
CAPABILITY PT t4ILL PROBABLY REQUIRP MEDICAL BOARD PROCEEDTNroS.
66. ATT OHYS: j'UNES, LTC 67. PH#; 'VOO ,)OO 000'v 68. @IARD#/PH#: 000 000 000 O'VOO
69, REPCRTC'D BY.- DENTC@' 70. Pq#.- (100 000@
74@ ATTENDANT NAME #li 7@'. STATUS: 76. GRADE:
71. A@oE- 78. SEX, 70A, 79. RELATIONSHIP TO PATIENT:
80. BAG TY,@'@t 81. BAG 'LAG 4@: 82. BAG '-.4T;
83. ATTENDANT NAME P.2: 64. STATUS: 85. GRADE;
86, AGE: 87. Sc,X., 87A. WT: 88. RELA Tlol\Zpj P TO PAT' NIT:
I
89. BAB TYPE-, 90. BAG TAG 91. BAB WT;
92. TRANS CRIB PHONE EXT:
03. TRANS DEST PHONE CXT
94. ETA ORIG MTF(DATE/TI@IE)@ 000 95. ETA DEBT 'i@iTF MATE/T IN E): 000
97, OTHER COMMENTS:
51. ISN #i CJOOO/360 52. 'RON LOC,.
57@ VALIDATED BY/@REAS FOR HIGHER PRr,-IIDENICE: 11
96. AIRCRAFT ITINERARY:
Document Page: First | Prev | Next | All | Image | This Release | Search
Document 7 f:/Week-32/BX000482/MEDSTAT - SITREPS DEC 90 4 OF 6/patient file:0906961515157
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 # = 7
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