Document Page: First | Prev | Next | All | Image | This Release | Search
File: 102896_aug96_decls3_0008.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
04,39:1@3 Fmticiii FILE 12/01' /90
PERSONAL DATA - PRIVACY ACT OF 1974
5 U.S.C. 552 (b)(6) 13. riODE: A
1. NAME: i 18. AUTHORITY #: 0351AI31 2. SSAN: 3. PRECEDENCE: R
4. STA@: All 5. GRADE: E02 6. AGE: 26Y 7. SEX: F S. @IT: 116 9. READY D.4Tcl; -)51
10. ISO, 11. POR,. 12. SPEC CAT:
14. REAS REG: DS 15. DATE LAST VISIT: 16. CLASS: IC
17. ACCEPT PHYS: JR@RO 19. APPTISURG DATE: NO
20, APPROV AUTH,. 21. CANC/INC: 22@ VALID: CWH Y5
23@ MTF CRIG- A5150 USA DISPENSARY DHAHRAN 24. ICAD DRIS: GEDR
25. M.TF DEST: A5030 FRANKFURT ARMY REG TRIED 26. ICAO DEST: EDAF
27. @MED SPEC I: MPPG 26. DIAB 1: 3004 NEUROTIC DEPRESSION
29. VED SPEC 2: 30, DIAG 2:
31. NED SPEC 3g 32. DIAS 3:
32A. PROCEDURE@
33. SPEC Dl,cT: M/ 34. IV:
3@@. 02/LPI: N 136. SUCT: N 37. NG TUBE: iN 36. RESP: N 39. FO-IFY@ N 40. STRYKER.- N
CAST/LGC-. N 45. TRACH: N 46. riON: N
71. PT BAB TYPE: NB 72. PT BAB TAG 73. PT BAG WT:
47@ SUPP INFO: 6&IRD ORD C@n SULWEINFURT, GEEWIN
48. MAX ENRTE STOPS: Y / 9 49. MAX # RONS: Y / 9 50. ALT REST/ViAX @qT: N
53. INPATIENT: Y 54. SPEC PROS: VA DRUG ALCOHOL WT NONE X 55@ VA CODE:
@6. ADMIN/DVERSEAS:
59. VITAL SIGNS(TEMP/PLILSE/RESP/DLOOD PRESS): 098.0 / 70 / 16 1 110 70
59. HGB: 60. HCT: 61. ABS: I DATE TAKEN:
62. WBC@ 63. SI/VS!: 64. MEDICATIONS: NONE
65. HISTORY: PNT WAS RECEIVING TREATMENT FOR DEPRESSION PRIOR TO BEING DEPLOYED
PAJIENT PRESENTED WITH A -.MALADJUSTIIENT DISORD-AR, INABILITY TO CARRY OUT
MISSION, PRESENTED WITH T-!AJOR DEPRESSION,
66@ AT-,, PHYS: STDNP-FIELD 67. PH#: 000 000 0000 68. WARD#/PH#: 000 / 000 000 0000
69@ REPORT D BY: DREYER 70. PH#: 000 0000
.E
74. ATTENDANT NAME #I: 75. STATUS: 76. GRADE:
77. AGE: 76. SEX: 78A. WT: 79. RELATIONSHIP TO PATIENT:
80. BAB TYPE: Bl@ BAG TAG 82. BAG WT:
83. ATTENDANT NAME 42: 84. STATUS, 85. GRADE:
86. A'oE. 87. SEX: 67A. 'AT@. 88. RELATIONSHIP TO PATIENT-
90. BAG TAG 91. BAG @lT@
92. TRANS DRIG PHONE EXT:
93. TRANS DEST PHONE EXT:
94. ETA DRIG MTF(DATE/TIME)@ 000 95. ETA DEST ?ITF(DATEITIME)t 000
,7. OTHER COMMENTS:
51. MSN #: 0000/351 52. RON LOC:
57. VALIDATED BY/REAS FOR HIGHER PRECEDENCE:
9b@ AIRCRAFT ITINERARY: f
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