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File: 092396_aug96_decls5_0013.txt
Page: 0013
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     



                                                                                    PA-I  C IT  FILE                                                    '211@19J9k!
                                                                                          Ilk t
                                                                 PERSONA" DATA - PRIVACY ACT OF l9t4



                                                                                                                                                    1'. RODE: A
                                                                          16. AUTHORITY 4: 0356AO29                           SBAN:                 3. PRP'U-DENCE: R
         4.  STAI:    All
                                             GRADE: E05                   6@ ACE: 24Y                7. SEX; F                8, WT@    14@@        9. READY DATE@ 356
         10. '601                         II. POR:                                 f                                                                12, SPEC CPT:
         i4. PEAS REB: DS                 15, DAE LAST VISIT:                                                                                       16. CLASS:
         i7. ACCEPT PHY@             JMRO                                                       5U.S.C. 552 (b)(6)                                  '9. APPT/9-JRG DATE: NO
         Lo. APPROV      ALITH@                                                                 21. CAi@IC/'@iNC:                                   21@. VALIDI                    CWH. I Y2
         23. @'@TF DRIG- A5150            USA DISPENSARY DHAHRAN                                                                                    24. 'CAD ORI&         CEDR
         2@@. mTF DEST: F@@070            Uc@A@cRi,iC WIESBADC@N' BE                                                                                -06. ICAU DPSTI       EDAF
         27. MED SPEC 1: SSG              28, DIAS 1: 79@-C)         NON@bPE@@IF-IC ABNOPMA" PAPANICOLAOU SV.,EAR OF CERVIX
  29. M-@D SPEC 2.                 0. DIAS
         @ll. rED SPEC 3:                 'o2. DIAS 3:
         3@@A. PROCEDURE:
         3 . SPEC DIET:              N/                                                         --,4, Ivi
         ,,5, 02/LPM; N'                  36@ SUCT:        i@        -@7. N@u TUBE: N           716.  R--@S@D: N'                            39= FOLEY:          N        40. STRYKER: N
         41. INCUB:          k'           4  TRA.@ ;       N         43. 1'rlE@; N              44@   P ST/LOC: N                            45. T@RAC@q:        N        46. MON@ N
                                          .2               CT                                           A
         71. PT BAG TYPE: NB                                         701. PT BAB TAB                                                         73, PT BAG     Wi:
         @'7, SUPP INFO. FT                                rg                                                                    47 CSH REPO
         RTED BY 44
         48@ MAX @CNRTE STOP@             Y   9                      49. j@'iAX 4 lot@'S,       Y    9                                       50. ALT RES@/MAX HT: N
         53. INPATIENT: Y                 54. SPEC         PPQ'O:  VA.    DRUG        ALCOHOL         k4T      NONE X                        55, VA CODE@
         5'0. ADvIIN/OVERSc@AS@
         S@  VITAL S'LGNS(TE@!O/PJL@-E/RESP/BLODD 'RESS)I 099@4                                 60    i4       122 /          66
         50. HBBT                         60. HCi:                   61, ADIG;                                                I DA'c TAKEN:
         6@'@ '4BC@,                      63. SI/V@'l:               64. DEDICATIONS NONE




         65. 41STORY: A.B@IORMAL PAP S@'@EP.R              14/ ATYPICAL CELLS IN APR & SEP OF 90. RECoillriEND
         FOR COLriSP@OID'C EXAil R'C-GUTRES CYTOLOGY, Cn,]-SF@LISCOPY, HISTOLOGY SUPPORT AND AV
         A"@ABIL!Tv OF TX.







 O'VO 0000                                             68. WARD#/PH#: 000 I 000 000 Orl,(@O
         ,,9@ REPORTED BY- LT JA@41S@,EE                                                                                      70. PH#: 000 0000
         74. ATTENDANT NAILE #i!                                                                                              75. STA.TU@                            76. GRADE:
         77. AGE:                                          78. FzX:                   76A. WIT:                               77. RELATIONSHIP TO PATIENT:
         80. BAG TYPE:                                     81. BAB TAB                                                        82. 4AC WT:
         83. ATTENDANT       NA-XC@ #2@                                                                                       84, STATUS:                            85. GRADE;
         86. AGEI                                          0,7. -QEXZ                 87A. WT:                                88@ RELATIONSHIP TO PATIENT:
         89. BAG T PE:                                     90@ BAG TAB                                                        91. BAB WT;
                      'Y
         52. TRANS CRIS      PHONE
         93. TRANS DEST      PHONE                               EXT:
         94. ETA ORIS MTF(DATE/TIM@c): 000                                                                                    95. ETA DEST MT--(DATE/TIt@,c)@ Or,
         97. OTHER COMMEN@'Tg;



         51,          #i 0000/'O@6                                                                                            @,2. RON LOC;
         Q@. VALIDATED EYIREAS FCR VIOT@EP PRECEDENCE:
         96. AIRCRAFT IIINERAPY:

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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