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File: 092396_aug96_decls28_0005.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
Q5:48:4C) **** PATIENT FILE **** 1.@/,@9/90
PERSONAL DATA - PRIVACY ACT Oc 1974
5 U.S.C. 552 (b)(6)
13. @ODE: A
1. 18. AUJHORITY #: 036IAO47 O@. SSAN:mm 3. PRECEDENCE: R
4. STAT: A'll 5@ GRAD---: D@'5 4. AGE: 3BY 7. SEX: S. WT: 115 9. READY DATE: 361
10, !So: 11, POO: 12, SPEC '@AT:
VISTT.
il. REAS RE'u; DS 15. DATE LAST '6, C!LASST 3A
17. ACCEPT PHYST U'14,iDo 19. APPTISURS DATE: NO
20, APPROV A@'jTH! 21. CAi\l@'/IN": 22. VALID: I TJU yg
c
23. MTF f-F !G: A5150 USA DISPENSARY DHAHRAN 24. IR@AG ORIG:
.OR
25. 4@i,c DEST: F5070 UgAr@R@'iC WIESBAEEN Oc 26 TCAD DEST: EDAF
CIFIED ANGINA PECTORIS
20. r!ED SPEC 2: 3(i. DIAG O@;
3lz NED SPEC 3: 32. DIAG 3:
32 A. PROCEDURE:
3-@. SPEC DIET2 Y/NONE 34. 'V:
o5. 02/LPri: N 36. S'UCT: 37@ NO TUBE; i,' ZS. RESP: i@ 39. FOLEYT N 40. STRYKERT
@ll . .-N@@UD:N 42. TRACT: @N 4-1. -iiIED; N 44, @@AST/'LOC: N 45. TRACH: N 46. i@Oi@! N
71. P@ BAG TYPE: ND 72. PT BAG TAB 73. PT BA' 14T:
47. gl@tic" INFO: 30 YIED BP L-- //N@F7 Cy'/ i%lo MONTT R NO 02 NO AITENDA,%IT
It -R . a
49@ @AX ENRTE Y / 9 47. '!AX 4 DONIS: Y I 7 @-0, ALT REST/@'iAX
5@. INPATIENT Y 54. SPEC @DROG: VA DRUG ALCOHOL WT INON@- 55. VA COn,
@6. AD@'(IN'/DVERSEAS:
58. VITAL S'LGNE(TEMP/P'U'LSE/R@ESP/BLOOD ORP-759): 099.@- @@6 / 16 / 102 54
DATE 'FAKENI:
j9. p@BB: 60. HOT: 61. ABS:
62. 14BC: 63. SI/V@i: 64. riPDICAT'ONS@ MPG SPRAY PRN
65, HISTORY: ADMITTED 23 DEC FOR CHEST PAIN -LAS' @@,4-PSi PAIN JULY 90 -
"N T
u,'Ki\'GWN ETIO"@u@uy - R-CQUIR.ES FURILIFR c,VA' OUT OF AOR
66@ ATT PPYS: OSBORN--- 67. P@'#: 878 745 6769 68. '@IARD#/PH#@ 037 945 843 8Q45
EPORTED BY: DREYER 70. P@@'#: 875 6875
74. ATTENDA-TNAME #I: 75@ STATUS: 76. 'uRAD@-:
77, A'DEI 70@. SEX: 78A. WT; 79. R-,LAi!C@NSHTP TO PATIENT:
80. BAS TYPE: al. BA@ TAB 82. BAG WT:
,u
ATi@NP@A?4T NAME #2i 84. 0,TAT@l-'S: 8,--. CRADE:
86a AGE: 87. SEX: 87A. @IT: Be, RELATIONSHIP TO PAT!Et4T@
39. BAG TYP;-:i 90, PAC AG 91. BAG WT:
92. -!RANO. ORIS PHONE EXT:
9-@. TRANS DEST PHONE EXT-.
94. ETA ORIG riTF(DAT /Tl@Mc); '100 95. ET n ST ',ITF(n T@/TIi'@iE): 000
A @A
97. OTHER 'UoririE4'i':
5i. MSN 4: OOA@0/7,61 52. RON ','IC:
T
,7. VALIDATED BY/REAS FOR HIGHER PRECEDENCE:
96. AtR@-'..RAFt ITINERARY: 11
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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