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File: 102896_aug96_decls2_0001.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: 6
PATIENT FILE 10122/90
51. AL DATA - PRIVACY ACT OF 1974 52, RON LOC;
57, VALIDATED BY/REAS FOR HIGHER PRECEBOR@' 1
96. AIRCRAFT ITINERARY. 56.S.C/ 552/(b)(6@
13. MODE: A
1. NAME: 18. AUTHORITY 0287AOI9 2. SSAN- 3. PRECEDENCE. R
4. STAT: All 5. GRADE- E07 6. AGE: 47Y 7. SEX: M B. @IT: 195 9. READY DATE- 289
10. ISO; 11. POR: 12. SPEC @IAT- 1
14. REAS REG, DS 15. DATE LAST VISIT: 16. CLASS: 3A
17. ACCEPT PHYS: JKRO 19. APPT/SURS DATE: NO
20. APPROV AUTH: 21. CANC/INC: 97. VALID.- SMF Y7
23. liTF DRIG: A5150 USA DISPENSARY DHAHRAN 24. ICAO ORIG: GEDR
25. MTF DEST: A@,040 2,%D GEN HOSP LANDSTUHL 26. ICAD DEST: EDAR
27, MED SPEC 1: NMI 20. DIAS 1: 4359 UNSPECIFIED TRANSIENT CEREBRAL ISCHEMIA
29. im.ED SPEC 2@ 30. DIAG 2:
31, VIED SPEC 3. 32. DIAS 3:
32A. PROCEDURE.
33. SPEC DIET. NI 34. IV:
39. FOLEY. N 40. STRYKER: N
41. INCUB: N 42. TRACT., N 43. IMED: N 44. CAST/LOC: N 45. TRACH: N 46. MON: N
71. PT BAG TYPE: NB 72. PT BAG TAG 73. PT BAG WTt
47. SUPP INFO: DS IGTH AIR BORN WIND FT BRAG NC
48. MAX ENRTE STOPS: Y 9 49. MAX # RONS: Y / 9 50. ALT RESTIMAX HT. N
53. INPATIENT: Y 54. SPEC PROG. VA DRUG ALCOHOL WT NONE X 55. VA CODE:
56. ADMIN/GVERSEAS:
58. VITAL SIGNS(TEMP/PULGE/RESP/BLDOD PRESS)- 098.6 86 / 20 / IBB 76
59. HGB. 60, HCT- 61. ABG-. I DATE TAKEN:
62. WBC: 63. SI/VSI: 64. MEDICATIONS: ASPRIN I TAB PRN
65. HISTORY: PT HAD A UffE ONSET OF LEFT ARM AND LEFT LEG NUMBESS WHICH LASTED T
HREE HOUR THEN RESOLVE ATTN PHY FEELS PAT NEED FULL INT WORK UP
66. PTT PHYS: PJAM 67. PH#: 000 000 0000 68. WARD#/PH#: 000 I 000 000 0000
69. REPORTED BY: SSG DENION 70. PH#: 000 0000
74. ATTENDANT NAVE #I: 75. STATUS: 76. GRADE:
77. AGE: 78. SEX: 78A. WT: 79. RELATIONSHIP TO PATIENT,
60. BAG TYPE: 91. BAG TAG 82. BAG WT:
83. ATTENDANT NAME #2: 84. STATUS: 65. GRADE@
ONSHIP TO PATIENT:
89. BAG TYPE: 90. BAG TAG 91. BAG WT:
92. TRANS GRIG PHONE EXT:
93. TRANS DEST PHONE EXT:
?4. ETA ORIG MTF(DATEITIME): 000 95. ETA DEST NTF(DATE/TIME): 000
97. OTHER COMMENTS:
51. MSN #- 52. RON LOC:
57. VALIDATED BY/REAS FOR HIGHER PRECEDENCE:
9b. AIRCRAFT ITINERARY:
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Document 41 f:/Week-32/BX000482/MEDSTAT - SITREPS OCT 90 3 OF 4/patient file:10019616503518
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 # = 6
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