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File: 092396_aug96_decls5_0002.txt
Page: 0002
Total Pages: 18

Subject: PATIENT FILE                                                    

Box  ID: BX000482

Document Number:          4

Folder Title: MEDSTAT - SITREPS  DEC 90  4 OF 6                                                               

Folder Seq #:          8

Unit: ARCENT      

Parent Organzation: CENTCOM     




                                                                                       PAT iE',@T F  T - ****                                                         l@/29/70
                                                                                                 i    iLc                                                             I
                                                                                  DATA - PRIVACY A@@i Fr lq7@



                                                                                                                                                                              A
                                                                                                                                                         ,3,          ','iODT -.
          1,    NAME:                                                         18, NJTHORITY #: O-,Z7AO'4 2. SBANT                                                     PRECEDENCE: R
          4.    STAT@ All                     5. GRADC@@ 001,                 6. AGE: 26Y                 7. SEX@ all                S. WT:    150       9.           READY DATE. 257
          lo@   ISO..                         11. POR:                                                                                                   l@.          OPEC CAT;
          14@   REAS R'CB4 DS                 15. DATE  LAST VISIT:                                                                                      16.          CLASS: 2A
          17.   ACCEPT PFYS:                                                          5   U.S.C. 552 (b)(6)                                              19.          APPTISURG DAT     \0
                                                                                                                                                                                 ,E
.          VALID:             I CWH       Y2
          23.   Y,,Tr' CR;G- ASISO            USA DISPENSARY D@'A@.RAN                                                                                   24.          ICA@C ORTr@'.  CEDR
          z3@   14TF DEBT; A@@040             2N'D CEN UDSP LA.IIDSTU4L                                                                                  26.          !P,AG      C@DAR
          I                                                             , @ERVERTEBRAL DISC DISORDER                     M@YEi-OPATPY, CERVICAL REGION
          ,7z   V@@ED SPEC 'i@ SOOC           28. DIAS 1: 72271         TNI-,
          29.   ilc-D SPEC 2.                 30. DIAG II:
          711.  ric@D SPEC 3:                 32. DIAS 3:
          32h. PROCED'u'REi
          33.   SPEC DIET:            N/'                                                            34. IV-
          ,%Z,, 02/LP@-'@: N          f       @-,6. SLICT:  t\l         1-17. NO TUBE: N              38.    RESP: N'                              @7.   F@ull@-Y:            @N' 40. STRYRER: N'
          41@   I@ICUB;               N       42. TRACI:     N          43.   !Mca: N,                LA.    CAST/LOC: N                           @'@5. TRAP@H:              N  46.            N
          7".   PT BAG TYPE@ NB                                         'f2.  PT BAG TAG                                                           73.   PT BAB       @4T:
          47.   SUPP INFO:            1123    S &  @@O        GOODw@A-ER, AL                                                            85T EVAC


          48.   r(AX FN@;.TE STOPS: Y             9                     4@,   ?l@AX # FICNS. Y            9                                        5L,.  A.LT REST/cIAX kT: N
                INPATIENT: Y                  @4@ SPEC PR'16@.       VA       DRUB        ALCOm'OL           'AT     NONE X                        55.   VA - DE:
                i     II
          '16@  ADViINI/CVERSEAS:
GD PRESS); 097@6 /                              60         'IO      108 1          82
          59;   PGD;                          60. PDT:                  61. A@r:               I             i                       DATE TAKEN:
          62.   ;4BC:                         63. SIIVSI.               64, ?IEDICATIO@.'Ig.@ TYLENOL 3 0 6 Y@




          65.   HiStORY-, C-6 RADIC@'LrjMYELO@'A-PiY SE,@r@IDANY TO H,14P WHO HAS DEVELOPED
          SIGNS OF SDlj\'AL CORD COMPRESSION'. @RE9@'.'IRES                                 INTERVENTION ASAP.


          REPORTED AS A PRIORITY PATTEN-i*y,********k*,iA! IDA@ D PY Fl@,rP,' SURGECK," t 1                                   I
                                                                                      iE                  I






          @46.  ATT P4YSi M.A." '@@@A'UH                   67. P4#2 000 000 0000                                              66.    WARD#/@OH#@ 000 I 000 000 O'VOO
          69.   REPORTED BY: JKRO                                                                                             70.    PH#: Slid 0000
          74.   ATTENDANT NAME #1:                                                                                            75.    STATUS:                                  76, ORADE-
          17,   AGE:                                       78@ SEXT                         ISA. '@,T:                        79.    RE',ATTONSHIP TO PATIENT:
          80.   BAB TY@0E.                                 61. PAS TAB                                                        92.    DA-3 WT:
          BZ,   ATTENDANT             NAME                                                                                    84.    STATUS:                                  85. C@ADE:
          86.   AGr@-                                      37. SEX@,                        87A, Y)iT:                        88.    RELAT!Gi\'S,44P TO PATIE,@'T@
                  01,    BAB @IT:
          92.   IRANS ORID PHONE                                     cx-:
          ?S.   TRANS DEST PHGNE O@                                  EXT:
          94.   ETA ORIG iyiTF(DAT'C          IIT@Wlp): 000                                                                   95.    ETA DEBT @iTF(DATE/T'ViE); 000
          97.   C@HCR Egli,@EP@i S.



          @l'.  M'OIN #@. 000@ii3i.,                                                                                          50-.   RON LOC@
          57.   VALIDATED BY/REAS FOR H-ISHER PRECEDENCE!
          96.   AIRCRAFT ITINERARY:                     f

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Document 18 f:/Week-32/BX000482/MEDSTAT - SITREPS DEC 90 4 OF 6/patient file:09069614061216
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 # = 16
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