The detainee states that he was captured by American forces in Baghdad, Iraq and was hit on the head with a rifle butt and kicked in the legs by a soldier during capture and once in custody.The medical report did not find any signs of injury.
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MEDICAL RECORD
CHRONOLOGICAL RECORD OF
SYMPTOMS, DIAGNOSIS, TREATMENT, TREATING ORGANIZATION (Sign each entry)
DETAINEE IN-PROCESSING MEDICAL SCREEN
. \
SUBJECTIVE: AGE F DOB: ANY NEW MEDICAL ILLNESS OR INJURY? f)-..;' ()
IANY HISTORY OF TB? YES I @ IF YES, WHEN AND HOW WERE YOU TREATED?
-
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-
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--_.-
CURRENT MEDICATIONS:
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MEDCOM -822
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0080-04-CID789
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Provider Signature: Printed Name I Stamp:
Routine Exam Form
Name: _...:-________ Date: __________
[SN: __________ 008: ______________ AGE: _____
Chief Complaint:
HPI:
PMH:
MEDS:
Allergies:
Physical Exam:
VS: BP P R 5a02 Weight
HEENT: Normal/Abnormal
CV; Normal I Abnormal
PULM: Normal I Abnormal
GI: Normal/Abnormal
GU: Normal/Abnormal
OB/GYN: Normal I Abnormal / NA
MS: Normall Abnormal
NEURO: Normal I Abnormal
DERM: Normal! Abnormal
ENDO: Normal! Abnormal
PSYCH: Normal! Abnormal
Comments / Findings:
--------I-Imp1'Cssion:
Disposition:
.~. 24
4
For Official Use Only
EXHIBIT;
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MEDCOM·824
Cornplaillt: Acute:
PMH: OM HTN STn TB
Hosp: Surg: A:7fj' ft,....,,·, I
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0080-04-CID789
History and Physical Exam Form
Kb)(6)-4
Name:Ll___--.--_____~-----'
ISN:-k,__________
vs: BP: i"ji'-;,..
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MEDCOM -825
DOD 003888
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USE THIS PAGE IF NEEDED. IF THIS PAGE IS NOT NEEDED. PLEASE PROCEED TO FINAL PAGE OF THIS FORM.
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STATEMENT OF _--L-____ TAKEN AT
----'-_____ ~\M Cl(A. f'"c;..:\ DATED ~\G.-'C-w' 0"
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INITIALS OF PERSON MAKING STATEMENT
I PAGE I OF I PAGES' -2 6
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PAGE 2. DA FORM 2823. DEC 1998
For Official Use Only
Law F.nforcpmpnt ~pn~itjvp
EXHIBIT: "7
MEDCOM -826
DOD 003889
for UIIlClal use vmy Law Enforcement Sensitive 0080-04-CID789
HEALTH RECORD
CHRONOLOGICAL RECORD OF MEDICAL CARE
DATE
I
SYMPTOMS, DIAGNOSIS, TREATING ORGANIZATION (Sign each entry)
PRE-TRANSFER MEDICAL ASSESSMENT
IS .·~l\Jt
"LIST ANY YES RESPONSES IN RAMARKS SECTION ON REVERSE SIDE OF FORM
AGE:~
(Y) (N) (Y) (N)
( ) (XL Allergies ( ) c,j'Recent i1lnosslinjury ,-
( I ( I [Jentat Prob·lems (-'T ( 1 History ol'psychological problems (Date; ? ._. ( ) cl ~!V po,itive (:'J( ) Chmnit.: health problC!ms or intt:(;(iuus Ui.s!.:ilSCS
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i FOR MEDICAL PERSONNEL USE ONLY DETAINEE'S INITIALS '-___1
-HIV,TUBERClJLOSIS QU ESTiONAIRE
Do you ha ..'c LI hi.s:CJry or, or do you presently have .Iliy of tht: following symptoms or conditions:
1=
-(VJ ( ) PersIstent cough/shortness or breath (t.1" (, ) Cough wilh blood and/or dry cough
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I.) I v1 ync'plained weight loss/diarrhea X 2 lVeeks (0' ( ) Unt!xplnined persistent r~\/er
----/
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PATIENT"S IDENTIFICATION lU.~ Lhls space for Mt:~lulllctll lml,rlOd RECORDS MAINTAINED ~ AT:
II S~.. .., 'v IV.; ., KANK/GRADE
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SPONSOR
----_.-
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MEDCOM -827
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DATE
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ANY NEW MEDICAL ILLNESS OR INJURY? N t!)
ANY HISTORY OF TB? YF.SJ~ IF YES, WHEN AND HOW WERE YOU TREATED?
,
COUGH 2 WEEKS? YES 1&
-_...
COUGHING UP BLOOD:
YES®
-ANY WEIGIIT LOSS? f!!j./NO IF YES. HOW MUCH AND IN WHAT TIME FRAME'? ~ k I LOltli ANY HISTORY OFHTN'! YES/@ ( ANY H1STORY OF CAD? YESI@§ IF YES. ANY HISTORY OF MI? YES I NO WHEN? ANY HISTORY OF DM? YES® IF YES. HOW LONG? ANY CHRONIC MEDICAL CONDITIONS NOT MENTIONED ABOVE? YES/~
-
-
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CURRENT MEDICAnONS:
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MEDICATION ALLERGIES;
~'KA ABLE TO WALK UNASSISTED? ~NO ABLB TO FEED YOURSELF? @I NO
-
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-
HISTORY OBTAINED THROUGH TRANLATOR? NAME:
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Medical Record STANDARD FORM 600 (AN. (;·971Pr.scriblld by GSAJICM ~ F1RMR l41 CFA) 201-9.202-' U~A"'~ QO
For Official Use Only
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l .... r
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MEDCOM -829
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SYMPTOMS. DIAGNOSIS, TREATMENT TR~T'NG ORGANIZATION (Sign filCh flfWyi OBJECTIVE: HEIGHT: f(: ~ WEIGHT: J1!C' 02%: TEMP;
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""~b~)(6~)-~4--------~~~--~1
Namt:~l______~________________~.
ISN:~I__________________
VS: BP:'-""/7'"l... ruhe: ~~I DOS; 7--il-} );1) AGE: ~s Resp: fj( Temp: Gclllder; A/Female fteigbt: fpV'
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MS: r~l. "-,
NEURO:,-If'DERM: 0 .......,/
ENDO:" PSYCH;
Phy,kal Rum: HEENT:
CV;
PULM:
GJ:
CU:
OBIGYN:
JIIIS:
NEURO:
DERM:
ENDO:
PSYCH:
Comments / f'llIdinp:
=" ,Attnormal Abnormal Or 1Abllorm.l
'e
~I Abnormld ~/AbnoTm:rl.1 Normal I Abllorm~11 ~Abnormal
Abn.ormal AbllormaJ
I Abnormal
Su.rg~ I"rf;i Pc "'''q AlLrl"glu:
,vl--::...
CXI2.: Normal / Abnf)rmlll
Findillgs:
PPD: Dllte plao:'cd:
Date ~ad:
_mm Imnlllllizalfolls: (giVt'R at tilb tim c)
MMR 'fd Typhoid Polio
NA
Pboto-gr&ph
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Da'~: ____~____ ISN: ___________________ 008: ____________ AGE: _____
Cbief Complaint: HPI:
PMH:
MEDS:
AlIer&ics; Physka] Enm:
vs: 8P p R Weight
»tENT: Nurmall AbnoTlul
CV: Normal I Abnormal
PULM: Normal} Abnormal
GI: Nonnall Abmormal
au: Normal' Abnormal
OBKlYN; Normal I Abllormsll NA
MS: Narmall AbnGrmal
NEURO; Normldl AbnorDl81
DERM\ N-ormslJ Abnormal
E:NOO: Normal I Abnormal
PSYCH: Ncirm\llll AbllClrma'
ComlDl!Rts Jricdings: Impru51C1f1:
4
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MEDCOM -834
For Official Use Only UiLt-U4-r.;m259-80 256
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MEDCOM -835
Lllw EnfONement Sen!oitivc ---0080-04-cr076'
HEALTH RECORD DETAINEE PRE-INTEROGATION EVALUATION
FaMily Practk:e Physician
For Official Ulle OnJy
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MEDCOM -836
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