Document Page: First | Prev | Next | All | Image | This Release | Search
File: 102896_aug96_decls4_0004.txt
Subject: PATIENT FILE
Box ID: BX000482
Unit: ARCENT
Parent Organization: CENTCOM
Folder Title: MEDSTAT - SITREPS OCT 90 3 OF 4
Folder SEQ #: 16
Document Number: 11
04@10-.25 PATIENT -@-Tl IO/ (1/9@@
PERSONAL DATA - PRIVACY A@ l@7c i974
CT
5 U.S.C. 552 (b)(6)
13, ilO'u@'t A
c
\!AM@-- iH. RITY : 03OIA041 2. SSANI-. 3. PRECEDENCE: R
18. A'jT i
4. ST T: Al' GRADE; EO@l 6. AGE: 22Y 7. SEXI F B. Wi@ 120 9. READY DATE: 301
@A. I I I
10, 1911: 11. POR: 12. SPEC CAT:
14@ Rc',AS DS 15. DATE LAST VISIT: 16. CLASS: 3A
17. ACCEPT P'HYS4 19. APPT/SURB DATE: NO
20@ APPROV A TH: 21. VALID: i JRL Y2
@u L2 1
,DR
I I.R
FDAC
45@ il-F DEST; F5070 USA@-I'MC LFSBADEN GE 26. ICAO DEST;
27. M@,D SPEC 1: 'rl)l 28. DIAG l@ 75481 PECTUS EXCAVATU@@s
49@ XiE'u SPEC 2: 30. DIAG
V.,ED SPEC 3: 32, DIAS 3:
32A. PROCEDURr'@
33. SPEC DIET: N/ 34. IV: 1
3@@. 0211@PO,@ N i' 36. SliCT@ Ni 37. NG TUBE: N' 36. RESP: Ni 39. FOLEY: N 40. STDYKER: Ni
41. INEUD: @4 42@ TRACT: N 4,-N@ IMED; N '@4, 'uASi/@@OC: N 45. TRA@'HI iN' 46. M.O@NI N
71. Ft BAG TYPE: NID 72. PT BAG TAB 73. PT SAO N@T:
47. BURP I,\IFG: FT CAMPBELL KY imERCY
48. VAX P-NRTE STOPS@ Y / 9 49. tItAX t RONS: Y 9 50. Al@T RESTI,'@AX 'P@T: N
Y,. INPATIENT! Y @@4@ SPEC ROG@ VA DRUG ALCOHOL NT NONE X 55. VA CODE:
@.6@ ADFiItVOVERSEP.S@
58. VITA Sit-ajNS@TEiIP/PULSE/RESPIDLOOD PRESS),. 098.0 83 12 / 110 64
@ 'IL
59. P@@uB; 60. @4.CT- 61. ABG: I I DATE TAKEN:
62. @-B'U: 671. SIIVSI: 64. ME'uIr.ATIO'idSi NONE
65@ LiiSTORY-@ PRESENTS WIUPPER 7YPHOID TENDERNESS & DIFFICULTY BREATHING.
66. 000 I 000 000 0000
60. REPORTED BYt riSG71 MAR'!IN@ 70. PH#: 000 0000
74. A TENDA,\TT INAME #'Z: 75. STATUS: 76. GRADE:
AT
77. h@G@@t 76@ SEX: 76A. l@'T@ 79. RELATIONSHIP TO PVITC,i@iT@
80. 'DAG TYPE; 81@ BAB TAG 4: 82. BAG t4Tt
9-@@ AT'E.@tDAN7! NA@,c@ *2: BB,. STATUS: 65. CRADET
96, AGE, 67. SEX; 87A. WT: 82. RELATIONSHIP T P @Ic T:
.0 Ai IN
69, PAC TYPE@ 90. BAG TAG 91, BAB ',,,IT:
92@ TRANS O,'(@LB PHONE EXT:
93, T AiNg DEST 0 o@,l@ EXT:
@R I 1 4 -
?4@ CT ORIS IITF@D4TE/Tli%E): 000 93. ETTA Dc@Si MTF(DATE/TI,'4iF-:)@ 000
.A
97@ OH'CR COriVEI\ITSi
51. @YiSiN '@: 0000/301 @,2. RON L@UC:
57. VALIDATED BY/REA@o FOR PRECEDENC-'-z
96@ AIRCRAFT T-ili\@'ERARY: f
Document Page: First | Prev | Next | All | Image | This Release | Search
Document 31 f:/Week-32/BX000482/MEDSTAT - SITREPS OCT 90 3 OF 4/patient file:10019616503620
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
Document Seq # = 11
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