PATIENT FILES 21 DEC 90

File: 102896_aug96_decls3_0003.txt
Page: 0003
Total Pages: 26

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


            04:37:32                                                               Ti C                                        12/2'/90
                                                      PERSONAL DATA - PRIVA@uy ACT OF 1974
                                                      5 U.S.C. 552 (b)(6)

                                                                                                                          13.  @@.ODE: A
                                                            Is. AUTHORITY 4,: 07@51AO56 .0. SSAN:                         3,   PRECEDENCE: R
     4.     STAT: All               GRADE: c,04             6. AGE: 24Y            7. SEX: tl          S. WT:     185     9.   READY DATE: 350
     10,    ISO-.               11. POR@                                                                                  12.  SPEC CAT:
     14.    REA-B RED: DS       15. DA     TLAST VISIT:                                                                   16.  'LLASS@ 2B
                                           :E
     17.    ACCEPT PHYS.-       JM.RD                                                                                     19.  ARPT/SURB DATEI NG
     2().   APPROV AUTH:                                                           Ill. CANC/INC:                         22.  VALID:                 LMK     Y7
     23@    MTF BRIG: A5s5O     USA DISPENSARY DHAHRAN                                                                    24.  ICAO BRIG:     OEDR
     25.    MTF Dc'ST@ F5070    USAFR.MC WTFSBADE@,' GE                                                                   26.  ICAO DEST:     EDAF
     27.    TIED SP-EC 1: 500   28. DIAS   1: 9597          OTHER AND UNSPECIFIED INJURY TO     KNEE, ',ED, ANKLcl., AND FOOT
     29.    MED SPEC 2:         30. DIAG   2@
     31@    MED SPEC 71:        32. DIAS   3:
     32A. PROCEDU@REI
     33.    SPEC DIET:          N/                                                 34. lVz   1
TUBE: N         38, RESP: N'                      39. FOLEY:            N  40. STRYKER- N
     41,    INCUB:              iN 42. TRA.CT@. N'          43, IMED- N            44. PAST/LOC: N                   45. TRACH:            N  46. ?10,4: N
     71.    PT BAG IYPE: NB                                 72. PT BAB TAB                                           73. PT DAG WT:
     47@    SUPP INFO: HHC I CAV FT HOOD,        TX                                                         47 CSH

     48.    MAX ENRTE STOPS: Y / 9                          49. MAX # RONS: Y      / 9                               50, AL    TREST/MAX HT; N
     53.    INPATIENT: Y        54. SPEC PROS:        VA    DRUG        ALCOHOL      14T     NONE X                  55. VA CODE:
     56.    ADIttIN/DVERSEAS:
     5&     VITAL SIONS@TEMP/PULSE/REEP/BLOOD PRESS@: 099.0                        88/20 /   120       94
     59@    HGB:                60. HOT:                    61. ABG:                                   DATE TAKE@.1-
     o2.    NBC:                6'@. SI/VSI:                64. MEDICATIONS: NONE    REPORTED




     65.    HISTORY; TORN LEFT P.CL '8 MO@N'THE AGO. NEEDS RECONSTRUCTION OF ACL K[TTH
     @RF7P@ABILITIOiN OF 9 - 12 MONTHS AND CYBAX EVAL W4ICH IS R@DINT              TNIUDUS.








     66.    .4TT PHY@           6'GSTO       67@ PP.#: t)O(l 000 0000                               68.  k'ARD4/PH#: 000       000 000 0000
     69.    REPORTED BY: POTTE                                                                      70.  PF,#: 000 0000
     74.    ATTENDANT NAME #1@                                                                      75.  SIATUS:                           76. GRADE:
     77.    AGE:                             76. SEX:                   78A. WT:                    79.  RELATIONSHIP TO PATIE.,NT@
     80,    BAG TYPE:                        81. BAB TAG                                            82.  BAG t4T:
            84@  STATUS:                           85. GRADC@:
     86.    AGE.                             87. SEX:                   87A. WT:                    88.  RELAT TONS@'IP TO PAIIENT:
     89.    BAG TYPE@@                       90. BAG TAG                                            91.  BAG @,T:
     92.    T ANS CRIE PHONE #t                       EXT@
            .R
     93.    TRANS DEST PHONE                          @@XTt
     94.    ETA CRIG MiF(DATE/TIME): 000                                                            95.  ETA DEST jITF@DATP/Tlrjz'): 000
     97.    OTHER COMMENT@



     51@    @;ISN 4: 0(@100/351                                                                     52. RON LO--@:
                                                            @E
     ,7.    VALIDATED BY/REAS FOR HIGHER PRECEDEN@
     96.    ATRCRAPT ITINERARY:


                                                                                   5 USC 552 (b)(6)

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