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File: 102896_aug96_decls4_0008.txt
Page: 0008
Total Pages: 31

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


       51. NSN @@@ 0000/301                                                                                52. RON LOC,.
       @7. VAL@DAT;
               I         -:r) BY/REA@. FOR HIGHER PRECEDENCE:
       9". AIRCRAFT TIYLNERARY!                     I










              03:59@51                                                   @ATIEN7t FILE                                                  10/30/90
                                                         PERSONAL DATA - PRIVACY ACT OF '974

                                                                 5 U.S.C. 552 (b)(6)
                                                                                                                                  i3.  MODE: A
       l@  NAME:                                                 18. AUTHORITY @: 030!AO'@7 2. ESANI:                             3@   PRECEDENCE: P
       4.  STAT: Al.!                 5@ GRADE: E03              6. AGE@ 20Y             7. SEX: il             8, WT.    190     9.   READY DAT---i 301
       10. IS@                        11. P03@                                                                                    il@. SPEC PAT:
       14. PEAS RED: DS               15. DATE LAST VISIT:                                                                        16.  CLASST 3A
       17. ACCEPT P@HYS:                                                                                                          19.  APPT/SURB DATE: NO
       20. @APPROV AUTH.                                                              21. CANC/INCi                               22.  VALID;                    j@RL   Y2
       23. FiTr@ ORIC-. P,5150        USA DISPENSARY DHAHRAN                                                                      24.  ICAO ORIG@       DE@.@D
       5.  MTF DESTI A"CI30           FRA,@IKFUF    @t AMY RED rtED                                                               26.  ICA.0 DEST:      @@DAF
                                                    ,R
S'uD          28. DIAG      1: 61600     CLOSED FRACTURE OF   PHALANX OR PDALANSES OF HAND, UNSPECIFIED
       29. mED SPEC 2:                3A,. DI@,G    2;
       31. FIED SPEC 3@               32. DIAS      3;
       @4A. PROCED'@IRET
       3'@. SPEC DIET@@               i@,'/                                           34.   TV:
       ,5. 021'          Nt           36. SUCT:     N'           -$7@ NS TUBE: N'     78.   R'CSP: N'                        39, FOLEY:         N'      40. STRYKER: N
       'Al. '-NOUBI      -.N          42. TRACTI N               4'@. ii@i;,:D@ N     44,   '@AST/LOCt Y        LA           45. TRACH:         N       46. ORION: N
       71. PT BAB TYPET NB                                       72@ PT DA - I    #@                                         73, PT BAG     tk]Tt
                                                                       AG IAO
       47. SLIPF inco@ FT qtEWART GA                                                                               28 CSH


       48, i@iAX ENRTE SIOPS@ Y          9                       49. t'iAX t RON@   Y    9                                   50. ALT REST/VAX HT: N I
                                                    R
       @3@ INPATIENT: Y               @.4. SPEC O OG:    VA      DRUG        ALCOHOL        '4T    NONE X                    @@5. VA CODE:
       56. ADV@Ti'@/GVERSEAS:
       @S, VITAL SIGNS(-,Ei@'t@ol'@OULSEIRESP/BLOOD PRESS): 098.2 11                72      18     10@O /       72
       59@ @4OD:                      60, HOT:                   61. ABS:                   I              I DATE TAKEN:
       62. iAIRCt                     63. SI/Vgl:                64. MEDICATIONS: NONE




       65, HIST09Y: WIDE REMOVED FROM               L THUMB, PATIENT PAS CAST ON' L '@,ANID.










       66. ATT PHYS: BROPHY                         67. P 0- 000 000 0000                                  68.  @IARD#./PH#: qOO / 00,0 000 0000
                      70.  PH@; 000 OOOC,
       74@ ATT
              .E@'4DANT NAME                                                                               75.  STATUS:                             76. GRADE:
       77. AGE:                                     78. SEX:                 78A. WT@                      79.  RELATIONSHIP TO PATIENT:
       80. BAB TYPE@                                81, BAB T fo                                           82.  BAG WT:
                                                                 .A
       63, AT ENDP.,N'T  NAME #2@                                                                          84.  STATUS:                             85. GRADE:
            IT
       S6. ACE:                                     87@ SEX:                 67A. 'AT:                     88.  RELATIONSHIP TO PATIENT:
       69. ef@ TYPE:                                90@ BAB TAB                                                 BAB @,T:
       92. TRANS 3R!G PHONE                              EXT:
       9@@ TRANS DEST PHONE                              EXT:
       94. ETA D@16 @iTF(DATE/T-[ViE): 000                                                                 95.  ETA DEST                           000
       97. 0 i HER C@i @'fEOTS:

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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