Medical Report: 20-Year-Old Iraqi Male, Baghdad, Iraq re: Gunshot Wound to the Abdomen

DOCTOR SHALL RECORD DATE, TIME AND SIGN EACH SET OF ORDERS. IF PROBLEM ORIENTED MEDICAL RECORD :TEM IS USED. WRITE PROBLEM NUMBER IN COLUMN INDICATED BY ARROW BELOW.
riENT IDENTIFICATION

DATE OF ORDER
TIME OF ORDER
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FORM
425
1 APR 79 REPLACES EDITION OF 1 JUL 77. WHICH MAY BE USED
r: MEDCOM - 15041
DOD-028430
CLINICAL RECORD - DOCTOR'S ORDERS
For use of this form, see AR 40-66, the proponent agency is OTSG
THE DOCTOR SHALL RECORD DATE, TIME AND SIGN EACH SET OF ORDERS. IF PROBLEM ORIENTED MEDICAL RECORD SYSTEM IS USED, WRITE PROBLEM NUMBER iN COLUMN INDICATED BY ARROW BELOW.
PATIENT IDENTIFICATION
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TIME OF ORDER LIST TIM ORDER `-2-111.)."- 0 -1 NOTED AND
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A 79
MEDCOM - 15042

DOD-028431
THE CLINICAL RECORD - DOCTOR'S ORD
For use of this form, see ARDOCTOR SHALL RECORD
4 0-66,

SYSTEM IS USED ERS
DATE, TIME AND SIGN the proponent agency is 07SG
WRITE PROBLEM PA
EACH SET OF

S STENT
IDENTIFICATION ORDERS. IF
NUMBER IN COLUMN INDICATED BY ARROW BELOW.
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A DATE OF Dante .
PATIENT IDENTIFICATION
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UNIT
FORM
APR 79
4256
REPLACES EDIT/ON
OF 1
MEDCOM - 15043
• -..
• BE USED

DOD-028432

CLINICAL RECORD - DOCTOR'S ORDERS
For use of this form, see AR 40-66, the proponent agency is OTSG
THE DOCTOR SHALL RECORD DATE, TIME AND SIGN EACH SET OF ORDERS. IF PROBLEM ORIENTED MEDICAL RECORD SYSTEM IS USED, WRITE PROBLEM NUMBER IN COLUMN INDICATED BY ARROW BELOW .
LIST TIME PATIENT IDENTIFICATION ORDER
+ DATE OF ORDER TIME OF_ zER OTED AND
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HOURS
NURSING UNIT (ROOM NO. BED NO.
1
MEDCOM - 15044
DOD-028433
CLINICAL RECORD THERAPEUTIC DOCUMENTATION CARE PLAN
For use of this form. see AR 40-407 ; (MEDICATIONS)
n n h • f on ral. Mo., 1/ Y r.c.?
INITIAL PROPER COLUMN FOLLOWING EACH ADMINIS7RAI7ON
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DA FORM 4678, 1 FEB 79
EDITION OF 1 DEC 77 WILL BE USED UNTIL EXHAUSTED.
USAPA V1.00
MEDCOM - 15045

DOD-028434
Verify by THERAPEUTIC DOCUMENTATION CARE PLAN
Initialing (MEDICATIONS) Mo. Yr.

Order ' Clerk/ Date to Time to
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MEDCOM -15046

DOD-028435
CLINICAL RECORD
THERAPEUTIC DOCUMENTATION CARE PLAN
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EDITION OF 1 DEC 77 WILL. BE USED UNTIL EXHAUSTED.
USAPA V1.00 it
MEDCOM - 15047

DOD-028436
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Verify by THERAPEUTIC DOCUMENTATION CARE PLAN
Initialing (MEDICATIONS) Mo. Yr.
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USAPA V1.00
MEDCOM - 15048

DOD-028437
CLINICAL RECORD THERAPEUTIC DOCUMENTATION CARE PLAN
For use of this form, see AR 40-407; (MEDICATIONS)
the or000nent aoenc i h s, i f T
VERIFY BY 'WHALING o MO.
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USE PENCIL.
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17 18 19 20 21 22 N 23 24 01 02 03 04 05 06

DA FORM 4678, 1 FEB 79
EDITION OF 1 DEC 77 WILL BE USED UNTIL EXHAUSTED.
USAPA V1.00
MEDCOM - 15049

DOD-028438

Verify by THERAPEUTIC DOCUMENTATION CARE PLAN
NAN,/

Initialing (MEDICATIONS) Mo. Yr. ....0:7j
Order Clerk/ Date to Tme to
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USAPA V1.00
MEDCOM - 15050

DOD-028439

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MEDCOM - 15051 USA'
DOD-028440

Verify by THERAPEUTIC DOCUMENTATION CARE PLAN
Initialing (MEDICATIONS) Mo. .

Date to Tone to

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SINGLE ORDER, PRE-OPERATIVES Time Given Initials
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MEDCOM - 15052

DOD-028441
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CLINICAL RECORD THERAPEUTIC DOCUMENTATION CARE PLAN
For use of this form, see AR 40-407: (MEDIC477ONS)
VERIFY BY INITIALING the proponent aoenc is the Office of The Suraeon General.

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USAPA VLOO
MEDCOM - 15053

DOD-028442

Pik

Verify by THERAPEUTIC DOCUMENTATION CARE PLAN
Initialing (MEDIC477ONS) Mo. '0 yr. 0 3
Order Clerk/ Date to Time to
SINGLE ORDER, PRE-OPERATIVES Time Given Initials
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USAPA V1.00
MEDCOM - 15054

DOD-028443

\ u) - (2_.\
CLINICAL RECORD
THE IAPEUTIC DOCUMENTATION CARE PLAN
For use of this form, see AR 40.407 ; (MED/CATIONS)
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MEDCOM - 15055 USAPA VT.00
DOD-028444
THERAPEUTIC DOCUMENTATION CARE PLAN
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USAPA V 1 .00
MEDCOM - 15056

DOD-028445

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CLINICAL RECORD THERAPEUTIC DOCUMENTATION CARE PLAN (MEDICATIONS)
For use of this form. see AR 40407:
the m000nent aaen is the Office clf_The_Sur aeon GenAral, Mo. Y 1. 6
VERIFY BY INTTIALING
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1MTIAL PROPER COLUMN FOLLOWING EACT-I ADIKINISIRA270N
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USAPAV1 .00
MEDCOM - 15057

DOD-028446

Verify by THERAPEUTIC DOCUMENTATION CARE PLAN
a, yr. ./.5.

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MEDCOM - 15058

DOD-028447
CLINICAL RECORD
VERIFY BY INIT74LING ORDER CLERK/
DATE NUR
THERAPEUTIC DOCUMENTATION CARE PLAN (MEDICATIONS)
For use of this form, see AR 4t407:
the nrnennent anenev in the nffil k of Th ? ¦ Jr. 1 ion (1 Mo. Y r. 40
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MEDCOM - 15059

DOD-028448

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MEDCOM - 15060

DOD-028449
CLINICAL RECORD THERAPEUTIC DOCUMENTATION CARE PLAN (MEDICATIONS)
For use of this form. see AR 40-407;
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USAPA V1.00
MEDCOM - 15061

DOD-028450

THERAPEUTIC DOCUMENTATION CARE PLAN
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MEDCOM - 15062

DOD-028451

CLINICAL RECORD 7IERAPEUTIC DOCUMENTATION CARE P
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USAPA V1.00
MEDCOM - 15063

DOD-028452
Verify by THERAPEUTIC DOCUMENTATION CARE PLAN Initialing (MEDICATIONS) Mo. LP Yr. n
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MEDCOM - 15064

DOD-028453
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CLINICAL RECORD THERAPEUTIC DOCUMENT
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USE PENCIL. CIRCLE MED TIMES D 7 8 9 10 11 12 13 14 E 15 16 17 18 19 20 21 22 N 23 24 01 02 03 04 05 06
DA FORM 4678, 1 FEB 79
EDITION OF 1 DEC 77 WILL BE USED UNTIL EXHAUSTED.
USAPA V1.00
MEDCOM - 15065

DOD-028454
THERAPEUTIC DOCUMENTATION CARE PLAN
Verify by Mo. Yr.
(MEDICATIONS)
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MEDCOM - 15066

DOD-028455