DOD Form: Detainee Transfer Form - Blank

Error message

  • Deprecated function: Return type of DBObject::current() should either be compatible with Iterator::current(): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 7 of /usr/home/documentafterliv/public_html/sites/all/modules/contrib/eck/eck.classes.inc).
  • Deprecated function: Return type of DBObject::next() should either be compatible with Iterator::next(): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 7 of /usr/home/documentafterliv/public_html/sites/all/modules/contrib/eck/eck.classes.inc).
  • Deprecated function: Return type of DBObject::key() should either be compatible with Iterator::key(): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 7 of /usr/home/documentafterliv/public_html/sites/all/modules/contrib/eck/eck.classes.inc).
  • Deprecated function: Return type of DBObject::valid() should either be compatible with Iterator::valid(): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 7 of /usr/home/documentafterliv/public_html/sites/all/modules/contrib/eck/eck.classes.inc).
  • Deprecated function: Return type of DBObject::rewind() should either be compatible with Iterator::rewind(): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 7 of /usr/home/documentafterliv/public_html/sites/all/modules/contrib/eck/eck.classes.inc).

Detainee Transfer Form - Blank

Doc_type: 
Other
Rec_aclu_path: 
https://www.thetorturedatabase.org/node/4306
Doc_pdf_path: 
Doc_rel_date: 
Tuesday, February 14, 2006
Doc_text: 

Transfer Form
Transfer: Urgent Priority Routine Convenience
(Code: Urgent: 2 hrs; Priority: 4 hrs; Routine: within 24 hrs; Convenience: when possible)
Condition: Litter Ambulatory Accepting Facility:
Name: Date:
ISN: DOB: AGE:
Chief Complaint:
HPI:

PMH:
MEDS: Allergies: Physical Exam:
VS: BP P R Sa02 Weight HEENT: Normal / Abnormal
CV: Normal / Abnormal PULM: Normal / Abnormal GI: Normal / Abnormal GU: Normal / Abnormal OB/GYN: Normal / Abnormal / NA MS: Normal / Abnormal NEURO: Normal / Abnormal DERM: Normal / Abnormal ENDO: Normal / Abnormal PSYCH: Normal / Abnormal
Comments / Findings:
Impression:
Disposition:
Provider Signature: Printed Name / Stamp:
Accepting Physician Comments:
784
DOD-045994

Doc_nid: 
4306
Doc_type_num: 
75