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File: 092496_aug96_decls38_0001.txt
Page: 0001
Total Pages: 2

Subject: PATIENT EVACUATION MANIFEST                                     

Unit: 22D SUPCOM  

Parent Organization: ARCENT      

Box ID: BX005121

Folder Title: MEDICAL SERVICES                                                                                

Document Number:          3

Folder SEQ  #:         43


                                   qc)



          PCN: RZE-PO2



           ----------------------------------------------------------------------------------
                                           PATIENT EVACUATION MANIFEST
                 Manifest No.:     EstimateA,De@    lire DTG:            Page _ of
                      al@              1-7 @ I          -
                 Medical Facility Plreparing'Mai)ifest:
                 21ST EVACUATION HOSPITAL                                  I     ng Ter@iinal:
                 ------------------------------------                      I
           -----------------------------------------------------------------------------------
              Nanie -- (3rade   Service Nuniber/SSAN      Eciergency Addressee -- Relationship
                  Diagnosis     Class of Patient          Address -- Town and State
           ----------------------------------------------        --------------------------------
       5 USC 552 (b)(6)
                          m              E3                    COMMANDER               CDR
           CHRONIC EPIDIDYMITIS            60499    3A         2220TH TRAUNS SWA



                                         E2                    RENATO PARADIANG        mom
                                                    3A



                                         E4                    COMMANDER
           IMUKHLIL, UUILTT SYNDROME                3A         B co 4/8



                                         E2                    COMMANDER USS ROUNDKE




                                         E5                    MARY DRAINCHAK
           LOWER 61 TRACT BLEEDING                  3A



                                         E5                    JEANETTE WALKEK         MOTHER
           HEPATITIS         573.3                  3A






                                                                                 5 USC 552 (b)(6)











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Document 2 f:/Week-34/BX005121/MEDICAL SERVICES/patient evacuation manifest:09209615584677
Control Fields 17
File Room = aug96_declassified
File Cabinet = Week-34
Box ID = BX005121
Unit = 22D SUPCOM
Parent Organization = ARCENT
Folder Title = MEDICAL SERVICES
Folder Seq # = 43
Subject = PATIENT EVACUATION MANIFEST
Document Seq # = 77
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 = 20-SEP-1996