Medical Report: 33-Year-Old Iraqi Male, Detainee, Mosul, Iraq re: Medical Screening Form: No Injuries (0253-04-CID259-80284)

a medical screening form for a 33 year-old Iraqi male detainee. The medical report does not indicate any abuse or current injuries. The report notes a burn on the patient's lower back, but gives no indication as to how the injury was incurred or the age of the injury, but that it is seen and treated previously.

Doc_type: 
Medical
Doc_date: 
Tuesday, May 4, 2004
Doc_rel_date: 
Sunday, April 17, 2005
Doc_text: 

, ­
Ol'S"l-oj-CI02S"/-2SO"l a-I Fo",Officlal Usa Only I Law Enforcement Se~ "tive 0106-04-CID7B9 -~.~.--~--------~\
I
~

I
i I I !
1
I

!c:~~'~';~'~~;¥:1~'~i~;; '::;:I \I I

\. (~) ~:-;. .fot,.-' .tl,.I jl
L.-,_~~~:-:-:---_
Phy:,icilt I :xnm:
!IITNT: I
l FIT FOifQUESTIOl\l1NG? rYfK i"N'U' I
I i
l.l :);(;5:
----.---'---..-----l-~-·-i
RFMAKS:
-S('f., A i /'( r.J1
TH~;\RT:
i
I
p,)!¥ ~~Gi,l 1..(
:,\BI)OMl:~'
SK.IN:
For OffIcial Use Only I law Enforcement Sensitive
MEDCOM -742

DOD 003805

Fo" Official Use Only I Law Enforcement Ser " 'ttve . . 0106-04-CID7B9
'-' i)l:S3-0l-UbZSCf-~OZ.S'7
"-'
(;. ' ..:.-. ~..
I •.•.•.
i

EXHIBIT:_5
For Official Use Only I Law Enforcement Sensitive
? o{,G U, g
MEDCOM -743
DOD 003806
,
For Official Use Only I Law Enforcement Se" -itlve 0106-04-CID7B9
tI.lS '3-()c(-C~t'2-S9-B'o 2.g 7
............ ......."

-
Level of Education: qLlJ GtJ}IJE IDegree:
School:
Specialized Training: /?L 13C. rRl (!JtJA./

Language Proficiency 1-Native 2-Good 3 =Poor
Lang:/1R/tBiCJ (1 2 3!Lang: 1 2 3!Lang: 1 2 3
EmOlovment

Position
Current NIN~~,'/) POWER. f;1.I+N"r
Location NltV Gv4 ~1(:E1I L
Duties rEL {;.eTJ?ICIIlN
PositionPrevious LocationDuties PositionPrevious LocationDuties
Additional Skills

Military Service
Branch ofServ: 11 PJ'Yl V IRank: .PVr
Service Number:
Military Training: f)1! VEtZ
,-
Military Experience Full Unit Designation ("fJ;L 8fJSlc! mlllAlIAl6 UIVP) IDates65iVlAf?88-10 Duty Pos: -PJ?J(;£{.. -IAdd Duties: Full Unit Des: -[Dates Duty Pos: IAdd Duties: Full Unit Des: IDates Duty Pos: IAdd Duties:
CategQFV (1 A =Highest I 3C =Lowest)
Cooperation '(1/ 2 3 Knowledge A B C
Screener Observations

Attitude: IAdditional Observations:
,
Recommended Approach: Screener Comments:
For Official Use Only I Law Enforcement Sensitive EXHIBfT: 3
3,oft u.) 9
MEDCOM -744
DOD 003807
Fo" Official Use Only I Law Enforcement Se" Itlve 0106-04-CID789
'-...I 02S 6-cH-C/b~·fo'2~7
"-'
-

-
SCREENING REPORT
r)(6)-4
Screener, Team #: I IDTG:2~ Aprolf of-;3 Capture Tag Number:I' Capturing Unit:
I

Biographical Information

EXHIBrT: ~
For OffIcial Use Only I Law Enforcement Sensitive
~o~G v, I t,
I.."
MEDCOM -745
DOD 003808

010s.-04-CI0789
02.S"3 -0"1 -c(p2 s9-8'0287

AUTHORIZED FOR l.OCAl. RE.PRODUCTION
CHRONOLOGICAL RECORD OF MEDICAL CARE
EDICAL RECORD \
~YMPTOMS DIAGNOSIS TREATMENT, TREATING ORGANIZA-rIQN (Sign each entry!
DATE tSAJ'*r6~ l
l~~~~= ../,=~~\Jd:._.-~-'---.---.....--.----.-..---.---.--.----....-....-..--.---.-.
~,. ._. ____ ._ •• _ ... __A ......______·_·____-·~------------·--··---..........­
_._-----_._._. _.._--_..._-_._.._........_----_._-_._----_.•. _._._._-_.__._......_........._--_.
_ .... ___.._._.....___.... __......___... _.....__..__.__... _-_..---..-_._u--_·----..--..--.---......._ .. --'
_..,,_._.._----_....-...._--_...........----_._--_....._---_.._......._........__._..----_.... ,_._-_ ...--..-------_.._.
_.......__._---------_......._-----_._----_.__...._.. ----------------­
-_._."'---'-"-'"
-----_.._-1--.__._---_._-_._--_._----_......__.._-----_..._ .....----.------....
------.._.-...-.--------~-....---...--.--...---.---.-----.----.--.----.----_.... _---_.­--.-.----..__.._-_.-.--'._--.... ------.-.--.----~-----------_......_._---------.._---_..----_.---.-­--------_....__......_--_....__.__..•._--_._---._------._-----------------_....­
---------..--.. f--....---.---..----------------------_._--._-----------­
-::-..__.__....---_._-_._--_.----------------_._­
-_._--.... _----_...._--_.._.._.__..__.._.._-_._-..._...____..•._ ...__.._ ..._ ...____..__ .,.. _.... ____ ....._ ._ow
-'.-.-'-_.-----.---.. .-._---,--_.._._---.....,,--_.._--..__._--_.._-._---_. -----~---._--.._._­-_..._---------....__.._._---._._------_.._....-_....._._.._-_._......_-----_._--_.'---'-­--_..._.. _--""-'---.----_._._-_._-----_.-._--_...._--_._-._-_._--_.-.._.._-_...
...._ .._....__....-._-.__.,-_._---------._......._-...__....__.._-------,._.._.__.. _----_..._--_.-.. _.__.. __...._---.

'IENT'S IDENTIFICATION: (For Iypecl 0, W,iII41n elll'ies, Q'''': N~me .,.$/, n,st, middle,.ID No 01 SSN; S_,,: D.'. 01 1REGISTER NO.
Binh: R8flI/G,,,d •.)
mpound V-A

ffib)illi(6)-4W------~ CHRONOL.OGICAI. RECORD OF MEOICAL CARE
r
Medical Record STA~DARD FORM 600 (REV. 6·97 Prescribed by GSAlICMR :nd M.P CO FIRMR (41 CFR) 201 ·9.202·' 'J:"'•• V'.OO
'EXH IBIT ,'3.
. For Official Use Only I Law Enforcement Sensitive
SJ',~11
-....
MEDCOM -746
........

DOD 003809
For lclal Use Only I Law Enforcement Sen81&'-1 0106-04·CID789
~....... ';)..,J. 02S 3-0'f-CID"2.S1~ 8'0.2.,,7

b)(6~2
TlmothyJKo m ,M,D. Major, USAF, Me
ISN:
CAMP; DOB:

STANDARD FORM 600 B4CK (REV. 5·84)
EXHiBIT:3
For OfficIal Use Only / Law Enforcement SensItive -
GrfJP 4. ('
~ __ v \·1
0 ~
MEDCOM -747
DOD 003810

Doc_nid: 
3350
Doc_type_num: 
72