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File: 092396_aug96_decls5_0011.txt
Page: 0011
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     



              06:32:17                                             **** PATI@c%@j- FILE ****                                               '2/29/90
                                                             PERSONAL DAIA - PRIVACY ACT OF 1974



                                                                                                                                     13,   j@,ODF; A
                                                                   @S. AU-1p.0-PTT
                                                                                             57ALI(12 2, SSAil                             PRECEDENCE: R
           4@ STA-I: Hii                u@Hu@: to;+                6@ AGE: 21Y               7. @@-EX; F       S.     WT:  110       9.    READY DATE;      57
           if,'. Isol                   POR@                                                                                         12.   SPE@ CAT@
           14@ REAS REG: DS          15, DATE  LOS' VISIT;                                                                           16.   P@LASS@ 2D
           17. ACCEPT                PHYST J'RO                              5 U.S.C. 552 (b)(6)                                     19.   APPT/SURG DATE: NO
           10. APPRCIV AUTH-                                                                 'II. CAN'@/INC:                         22.   VALID:                  CWH      Y5
           23. riTF CRIG-, A5150     USA DISPENSARY DHAP,,RAt%'                                                                      24.   ICAG ORIG;       C@@DR
                                                                                                                                     26.   ICAO DEST:       EDAF
           ,5. @ITF DEST: A5030      cRANKFURi ARMY R'as i!ED
           27. riED SPEC I- V@MU     'Ls. DIAS 1: 49390      ASTH.@N4, UNSPECIFIE@ T PE, ST TUS            hSTP@i@iA-ICLIS NOT MENTIONED
A
           29. r,.ED SPEC 2:         30. DIAG 2@
           3i. MED SPEC 3:           30@. DIAC 3:
           32A. PROCEDURE:
           3. SPEC DIET:             NI                                                      34. IV: 1
           35@ 02/LPMi @N'           36. SU@,T:      N       37@ MG TUBE: N                  38. RESP:                          7@9, FOLEY:          N      40. STRYKER: N
           41. !NCUS:                N4@-1. TRACT: iN        43. IIFD: %I                    44. CASTI,'L.3C.- N                45.  TRACJ;          N'     46. @ON: N
           71. PT BAG TYPE: NB                               72. PT BAG TA,@,                                                   73.  PT BAG ViT:
           47@ SUPP INFO: FT BRAGG, NC //28

           48. MAX c,NRTc, STOPS: Y / 9                      49. M@AX # RONS; Y              f 9                                50.  ALT REST/11AX HT: N' 1
           -7                        Y54. SPE@ Po P:         VA    DRU@      A' OHnuL        6!T               X                55.  VA CODE:
           D.. !NPATIENTA                                                      IC                          I
           @6. ADIIIN/DVm' S'CAS:
           59@ VITAL SiGiNS(TEMP/PULS-t/RESP/B'@@OD PRESS): 098.0                     72     /1.6     120 /           70
           @9. HOB@                  60. 'HOT:               61. AB'@:                                         DATE TAKEN:
           62.                       4,3. SI/VSI:            64. P@c@DICATIONS: PRE.@14133@4E        40MG PC DAILY,
           PROVEiNT'i !NH@"@OR MD    T2 PUFFS DID, T-:O@HROMYCIN 500t.16 DID



           65. HISIORY; LONG HISTORY OF ASTHMA               ACUTE ASTHMA ATTACK RC@CIUIRING SYSTEi@tTr
           STEROIDS. PATIENT         TS STEROID DEPENDEN- AND CANNOT TN.LERATE EpiVIROF,@cN'T
           c                         f
           NEEDS FULL PULMONARY C@VAL AND POSSIBLE ri--B.







     68.    WARD#/PHO.; 000      000 00@ 000,')
           69. REPORED BY: DREYER                                                                              70,    PH4: 000 0000
           74. ATTENDANT NAME #I:                                                                              75.    STATUS:                           76. GRADE:
           77. ASP-:                                 78. SEXT                  76A. V,T:                       79,    RELAITONSHIP TO PAIIENT:
           Fi. BAG TYPE:                             81. BAG TAG                                               62.    BAG @14T:
           83. ATTENDANT             NAYIE #2:                                                                 84.    STATUS!                           S'@. GRADE:
           86, A C.                                  87. SFX;                   07A. 6T:                       88.    RELATIONSHIP TO PATIENT:
           .G-.
           89. BAG TYPE:                             90. BAG TAG                                               91.    BAG WT:
           92. IRAN CRIB PHONE                               CIXT:
           93. TRANS DEST PHONE                              EXT:
           94. ETA DRIG MTF(DAiE/TIr,'C): 000                                                                  95.    ETA DES' MT@-(DA-iE/Tl'@i---): 000
           97. OTHER COMMENTS:



           51. rSN #: OOOO/ 57                                                                                 52. RON LO@@@
           57@ VALIDATED BY/REAS FOR HIGHER PRECEDENCE;
           96, AIR@@RAF              TITI@4ERARY@                                                I                    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