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File: 092396_aug96_decls28_0004.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
PATIENT FILE 12/29/90
DATA - PRIVACY ACT OF 1974
5 U.S.C. 552 (b)(6)
,3. r@@ODcl: A
1. NIA.M.E; 'S. AUTHORITY 4: O@IA046 2. SSAIN: 3. PRECEDENCE: R
4. ST Ti All 5. GRADE: E06 6. PGE@ 19Y 7. SEX: @l S. WT@ 215 9. READY DAIE: 36'
@A I
10. !So: 11. POR: 12. SPEC CAT: f
14. R@-A-@' REG: DS '5. DATE LAST VISIT: 16. CLASS: 3A
17. ACCEPT P@'YS: j@,Do '9. APPTISURC DATE- N'G
20. APPROV AUTH: 21@ @,ANC/INC: 2'L. VALID@ TJH Y9
23, t@,-iF N@RIG: A5150 USA DISPEN.SARV DHAHRAN 24, ICAD ORIS: OC@DR
25. @'OTF DEST: A@@040 2N,,D GEM HOSP LAiNDSTUtHL 26. ICAO DEST: ---BAR
K---MIPLEGIA, UNSPECIFIED
29. SPEC 2: 0. DIAS 2:
31, II.ED SPEC 3: 32. DIAS 3@
.52A.. PROCEDURE:
33@ SPEC D TET: N/ 34. !V:
35@ 02/LPri; N '-z6. Q-L,'C-i :N 37@ K@B TUBE: N@ 38. F;-:Sp; N 39. FOLc@y: t4 4'v. STRYKER; N
41. l@l@IUB: N 42. IRACT- 43 . TFi-- : N 44. CAST/LDC; N. 45. TRAPILI.: N 46. iOi\': N
@ D
71, PT BAG TYPE: NB 72, PT BAS TAG 4: 73. PT BAG WT:
47. SUPP IN@o: FHC 265 E@,NGR Fi STEV,'ART GA///iIERCY/l/
48. MAX EE@RTE STOPST Y / 9 49. MAX # RONS: Y / 9 "0. ALT REST/NAX HT@ N
53. !,%'PATIENT: Y @@4. SPEC PROG: VA DRU,@O ALCOHOL WT MGM- X 55. VA CODE:
56@ ADV@It4/OVERSEAS:
58@ VITAL SIGNS(TtEriP/PULSEIREEP/BLGDD PRESS): 0?7.0 f 68 / 16 / 112 68
59, @@'GB: 60@ HCT: 61. ABB-@ DATE TAKEN:
62, WBC @ 63. SI/VS-it 64. MEDICATIONS: BLYDRIDE 5 rG BID, ATENGLu'!- @0146 QI
D: ASA 2 TABS DID
65, HISTORY: ADMIT TD 23 DEC 90 - CT 14NL - 8 YEAR H TST' v OF DIABETES
R,
OSBOD 67. PH#: 878 796 9666 66. WARD#/PH@: 678 786 976 6987
69. REPORTED BY: DREYER 70. PH,*: 12,-% 4564
74. ATT NDA@T NAME @l: 75. STATUS: 76. GRADE:
.E
77. ACE: 78. SEX: 76A. WT: 79. RELATIONSHIP TO PATIENT:
80@ BAG TYPE: 81. BAG -JAG @.t 62@ BAG !IT:
63. ATTENDANT NAME #2i 84. STATUS-. 85. CRABS:
66@ AGE: 87. SEXT 87A. WT: 86. RELATIONSHIP TO PATIENT:
69. BAG TYPE: 90. BAG TAG 9,. BAG WT:
92. TRANS DRIS PHONE EXT:
93. TRANS DEST PHONE EXT:
94. ETA DRIG jITF(n TE/TIME): 000 O@. ETA DEST MTF(DATE/T!ViE): 000
97. OTHER COMtiENTS!
51. IMSN #: 0000/'@61 52. RON LO@.@
57, VA.'@IEIATED BYIREAS FOR HT OVER PRECEDENCE:
96. AIRCRAFT -IT7 NERARY: f
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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