Document Page: First | Prev | Next | All | Image | This Release | Search
File: 102896_aug96_decls3_0004.txt
Subject: PATIENT FILES 21 DEC 90
Box ID: BX000482
Unit: ARCENT
Parent Organization: CENTCOM
Folder Title: MEDSTAT - SITREPS DEC 90 2 OF 6
Folder SEQ #: 6
Document Number: 5
04:37:50 PATIENT FILE 12/21/90
PERSONAL DATA - PRIVAPT ACT Or- 1974
5 U.S.C. 552 (b)(6)
13, MGv@; A
NAVE@ 18. AUT40RITY #: 035IAO53 2. BSA%': 3, r'RECEDEN"@E: R
4. S@TAT: All 5. GRADE: c@06 6. AGEI 31Y 7, SEX: I B. 14T@ i67 9. READY DATE: 350
10, Isot 11. PORT 12. SPEC CAT:
14. REAS REG. DS 154 DATE LAST VISIT: 16. CLASS: 3A
17. ACCEPT PHYS; JMRO 19. APPT/'auRB DATE@ NO
20. .4PPROV AUTH@ 21, P INC/TINC: 22. VALID@ I Lr@-K I Y7
,A I
23. MTF DRIG@. A5!50 USA DISPENSARY DHAHRAN 24. ICAO CRIB: GEDR
25. ITF DEST: F5070 USAFRMC '@-VIESBADEN BE 26. ICAO DEBT: EDAF
27. 4@ED SPEC I z LIO 28. DIAG It 71883 OTHER JOINT DERA\',BEric@T, CEC INVOLVING FOREARM
29. MED SPEC 2: 30. DIAG 2:
31@ IVIED SPEC 3@ 12. DIAS 3:
32A. PROCEDLIRE:
33. SPEC DIET@ Nl/ 34. IV: 1
CT: N 37, NIB TUDE@ N 38@ RESP: N 39. FOLEY: k,' 40. STRYKER: N@'
41. lNuUB: N42. -I.RACT@ N 43 .TTIED: N 44. 'UAST/LOC: N 45. TRACH; N 46. i@,ON: N
71. PT BAB lyPE: NIB 72, PT BAG TAB 73. PT BAB @IT:
47. SUPP INFO: 68 CHEM I CAV FT HOOD, TX 47 CSH
48. MAX ENRTE STOPS: Y 1 9 49. MAX 4 RD\,S: Y / 9 50, AL' R@CtT/FPX HT: N
53. IMPATIENT: Y @A@ SPEC PROS: VA DRUC ALCOHOL WT NONE X '@;5, VA CODE:
56. ADIliTkl/gVERSEAS@
I
A
58. Vil@L SIGNS(TEimiP/PULSE/RESPIBLOOD PRESS): 0918 96 /18 1 I--,O 90
59. @GB: 60. HCT@ 61. ABG: DAIE TAKEN:
62. ',@,IBCi 63@ SI/VSI., 64@ NONE REPORTED
65. HISTORY: PA'lj\'FUL RIGHT t4RIST SIR WRIST F@,SSI'ui\" IN, 1928. HAS DJr.' OF 'PIC@
'F/MF @riL JOINTS, PHYSICIAN DESIRES riPB
66. AIT PHYS: '@OSIO 6@, l,",OO 000 0000 68. ARr.#/Ph#; 000 000 'VOO 0000
6?. REPORTED BY: POTTER 70. O@lo 0000
74. A7TENDAi\"-' NAME 75. SiATUc,: 76. GRADE:
Al@ONSP@IF TO PATIENT:
11, ASE@ 78. SEX@ 78A, t@ITt 79@ RE' TT
81. BAB T I LI:
80. BIAS TYPE: @Au B'@. BAG ';i'T@
83, PTTENDPHN" NAME 42; B4' . STRATUS- 6@. IC:
@Al
86. AGE: 87. @-@X@ 87A. @l: ES, -;C, OATIPNT:
99. BAG TYPE: 90. BAG TAB 91. BAB
92. TRANS CRIS PHONE --XT-
9-@ TRANS DEST PHONE EYT-
T
94. ETA i4.-!F(DATc@"-iii-i 000 95@ P@iA DEST MTF7(D@ATE/TT,@-'-)@ OCIO
91-
@k)00/35i 52@ RON LOCI
@17. VALTDAT n By/ EA.S =OR HIGHER K@---CEDEN'CE! f
@ E@
0 AI'CRAF! ITINERARY!
,6,
5 USC 552 (b)(6)
Document Page: First | Prev | Next | All | Image | This Release | Search
Document 26 f:/Week-32/BX000482/MEDSTAT - SITREPS DEC 90 2 OF 6/patient files 21 dec 90:10019616503519
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 2 OF 6
Folder Seq # = 6
Subject = PATIENT FILES 21 DEC 90
Document Seq # = 5
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