Document Page: First | Prev | Next | All | Image | This Release | Search
File: 102896_aug96_decls1_0007.txt
Subject: PATIENT FILE 29 OCT 90
Box ID: BX000482
Unit: ARCENT
Parent Organization: CENTCOM
Folder Title: MEDSTAT - SITREPS OCT 90 3 OF 4
Folder SEQ #: 16
Document Number: 10
06:48!45 PATIENT FILE '0/29/90
PCISOI\]AI DATA - PRIVACY ACT OF 1974
13. M'UDE: A
1. 18. AUTHORITY #: 029BA045 2. SSANT 3. PRECEDENCE: R
4, STAT. Ali 5@ GRADE: E05 6. AGET 24Y 7. SEX: F 8. WT- 17@ 9. READY D.A-,E@ 298
10@ 150: 11. POR: 12. SPEC CAT:
14. REAS RES: DS 15. DATE LAST VISIT: 5 U.S.C. 552 (b)(6) i6. CLASS: 3A
17. ACCEPT PHYS: JFIRO 19. APPT/SURG DATE: NO
20@ APDROV q'u'TH: 21. CANC/!N'@: 22. VALID: Lm, Y4
23, MTr' GRIG: A51@@o USA DISPENSARY DHAHRAN 24. l@@AD ORIS: OC@DR
MTP DEST: A@@030 FRAN,@FI-IRT ARMY RES rED 26, ICAD DEST: EDAF
27. ?@ED SPEC 1: MMLI ?-B. DIAG 1: 49391 ASTP@MA, UNSPECIFIED TYPE, WVF@, STATUS AST,'YATICUS
29. NED SP'-CC 2@ 30. DIAS 2@
NED SPE' 3: 32. DIAS
@2A. PROCEDURE;
SPEC Dlc@T: @NI 34. !V:
35. 02/LPim@: N 36. SUCT: N 7. NG TUBE: N 38, RESP: N 39. FOLEY: N 40. STRYKER: N
41.TNCUD: N IL?. TRACT:N 43. IMED: N 44. CAST/LO@: N 45. TRACH: N 46. IMONI: N
71@ PT BAG TYPE. NB 72. PT BAG TAG 73. PT BAG Wi:
47. Slj'PP INFO: HHB 75iH FA DOE; CT STEWART, GA REPORTED BY
23,@S4
48. N'jAX E.@IRTE STOPS: Y 9 49. MAX @ RONS: Y / 9 50. ALT REST/imAX HT. N 1
53. ',NOATIcINT@ Y 54. SPEC PR-1@G: VA DRUG ALCOHOL WT NONE X 55. VA CODE:
@i\'/GVERE@-Ah:
,6. ADMT
58@ VITAL SIGNS(T ilP/PULSE/RESP/BLOOD PRESS): 098.6 72 1 12 110 70
@E
61. ABG: DATE TAKEN:
@9. ROD: 60, HCT:
6-z, NBC: 63. SI/Vgl: 64. MEDICATIONS: THEODUR -NOO,@.S qlDIPREDNISONE 40MG D
C@D/PROVENTIL INHALER 2 PUFFS QID/li\'iA" INHALER 2 PUFFS OID
65. HISTORY: P,HRDINTP AS'uilA; ACU'@ cLAI@R FOR PAST 2 W@ z UNRESPONSIVE TO USUAL
t@@ a Is
@@EDS. A/E OUT OF ADR FOR FURTHER EVNL AND T4ERAPHY; PROBABLE , NIGN-DEP'@InYABI-E
- T
iD SA'UD@ ARABIA.
A-6. ATT PH.YS- YOST 67. P,411: 000 000 0000 66. WARD#/PP@#: 000 000 000 0000
69. @EPOOTED BY: DENTON 70. PH#: 000 0000
74. 4TTENDANT NAME #I: 75. STATUS: 76. GRADC@;
78. SEX: 78A. k'T@ 79. RELATIMHI@ TO PATIENT;
80. BAG TYPE: 81. BAG TAG 82. BAG WT:
S.'@ ATTEN'uANi NAME lt2; 84. STATUS: 85. GRADE:
96. AGE: 97@ S'En 87A. -4T: 8B. RELATIONSHIP TO @ TIC I;
.A. @N@
69. BAG TYPE: 90@ BAG TAG 9i. BAG WTt
92. TRANS CRIG PHONE EXT:
93@ TRANS DEST PHONE EXT:
94@ ET AORIS MTF(DA E/Tlt'iE): OqO 95. ETA DEST ViTF(DATEIT'Vic): 000 I
I AT
97. OTHER COMMENTS:
@ll. il'ts@ : 00011298 52. RON LOCT
@17. VALIDATED BY/@R@cAS FOR HIGHER PRECEDENCE:
96. AIRCRAF, ITINERARY: I i
Document Page: First | Prev | Next | All | Image | This Release | Search
Document 46 f:/Week-32/BX000482/MEDSTAT - SITREPS OCT 90 3 OF 4/patient file 29 oct 90:10019616503417
Control Fields 17
File Room = aug96_declassified
File Cabinet = Week-32
Box ID = BX000482
Unit = ARCENT
Parent Organization = CENTCOM
Folder Title = MEDSTAT - SITREPS OCT 90 3 OF 4
Folder Seq # = 16
Subject = PATIENT FILE 29 OCT 90
Document Seq # = 10
Document Date =
Scan Date =
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 = 01-OCT-1996