Medical Report: Iraqi Male Detainee, Baghdad, Iraq re: Gunshot Wound

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STANDARD FORM 509 (Rev. 11 -77)
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MEDCOM - 5210
DOD 12422

MEDICAL RECORD PROGRESS NOTES
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DOD 12423

PROGRESS NOTES
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DOD 12425

PROGRESS NOTES
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(b)(6)-4 PROGRESS NOTES STANDARD FORM 509 (Rev. 11-77) Prescribed by GSA/ICMR, FIRMR (41 CFR) 201-45.505 509-111
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DOD 12428
MEDICAL RECORD PROGRESS NOTES
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STAMARDFORIA 509 (Rev. 11-77)Prescribed by GSANCMR,
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M EDCOM - 5217
DOD 12429
PROGRESS NOTES
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MEDCOM - 5218
DOD 12430
MEDICAL RECORD PROGRESS NOTES
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STANDARDFORM 509 (Rev. 11-77)
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FIRMR (41 CFR) 201-45.505

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MEDCOM -5219
DOD 12431

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DATE
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PROGRESS NOTES STANDARD FORM 509 (Rev. 11-77) Prescribed by OSA/ICMR, FIRMR (41 CFR) 201-45.505 50D-111
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DOD 12432
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DOD 12433

PROGRESS NOTES
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MEDCOM - 5222
DOD 12434
MEDICAL RECON) PROGRESS NOTES
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PROGRESS NOTES
STAI iAD FORT 509 (Ray 11-77) Prescribed I GSA/ICMR.
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MEDCOM - 5223
DOD 12435

MEDICAL RECORD PROGRESS NOTES
DATE
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MEDCOM - 5224
DOD 12436

PROGRESS NOTES
L ° DATE
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•
MEDCOM - 5225
DOD 12437
NURSING NOTES
(Sign all notes)
HOUR OBSERVATIONS
DATE
A.M. P.M. Include meditation and treatment when Indlcakd
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GIONSING NOTES Standard Form 510 (Reverie)
GPOI 1987-181-247/60056

MEDCOM - 5226
DOD 12438

CLINICAL RECORD NU/WWI NINES
HOUR OBSERVATIONSDATE A.M. P.M. Include medication and treatment when indicated
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NURSING NOTES
Standard Form 510
Prescribed by GSA/ICMRFIRMR (41 CFR) 201-45.505
. 510-110
MEDCOM - 5227
DOD 12439

NURSING NOTES
(Sign all noses)
HOUR OBSERVATIONS
A.M. P.M.. Include medication and treatment when Indicated
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* U .5 . GOVERNMENT PRINTING OFFICE ; 1983 0 421-526 (9201) NURSING NOTES Standard Form 610 (Reverse)
M EDCOM - 5228

DOD 12440

CLINICAL RECORD N Urs4;;N 'Or NOTES
HOUR OBSERVATIONS
DATE
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(For typed or written signet give: Name—law, first,
REGISTER NO. WARD:Ne. middle; grade; dare; hospital or medical facility)
(b)(6)-4 NURSIG NOTES Standard Form 510 General Services Administration and Interagency Committee on Medical Records FPMR 101-11.808--8—October 1975 510-109
MEDCOM - 5229
DOD 12441

NURSING NOTES
(Sign all notes I
HOUR OBSERVATIONSDATE
A.M. 'TA. Include medication and treatment when indicated
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* U.S. GOVERNMENT PRINTING OFFICE = 1983 0 421 ­526 (9201) NURSING NOTES --Standard Form 510 (Reverse)
MEDCOM - 5230

DOD 12442

CLIRCAL RCFD NUM M12( MO. ES
HOUR OBSERVATIONS
DATE

A.M. P.M. Include medication and treatment when indicated
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NURSING NOTES
(b)(6).4
Standard Farm 510
General Services Administration and
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FPMR 101-11.806-8--October 1975
510-109
MEDCOM - 5231
DOD 12443

HOUR
DATE
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(Reverse)
MEDCOM - 5232
DOD 12444

CLINICAL RKORD NUASJNall MORS
HOUR OBSERVATIONS
DATE
Include medication and treatment when indicated
A.M. P.M.
49
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• (b)(6)-4 , r
NURSING NOTES
Standard Form 510 General Services Administration and
FphR 161-11.1366-8—October 1975 510-109
MEDCOM - 5233
DOD 12445

HOUR
DATE 44 Ott• . ,P.M,. ,-,
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NURSING NOTES
(Sign all notes)
OBSERVATIONS Include medication and treatment when indicated
1 .
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* II.S. GOVERNMENT PRINTING OFFICE = 1983 0 - 421-526 (9201) NURSING NOTES
Standard Form 810 (Reverse)
MEDCOM - 5234
DOD 12446

CLINICAL RKORD NU rs5;,Ua NOTES
HOUR OBSERVATIONS
DATE
A.M. P.M. Include medication ond treatment:when indicated itgrej . goreiWA /4.-,V /9,1170:0-sep ,o, ePiet5-"&s7 ..",r3 0 -49r- /1Pec).4"3 410 ..01:1e....Mre.
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Continue on reverse side
PATIENT'S IDENTIFICATION
(For typed or written entries give: Name—lost, first, REGISTER NO. WARD NO.
middle; grade; date; hospital or medical facility) 1(0(6)-4
NURSING NOTES
Standard Form SIO
. . General Services AdminIstration and
regency re ee o 510-109
Committee Medial. 1Recordss
MEDCOM -5235
DOD 12447

NURSING NOTES
(Sign all notes)
HOUR OBSERVATIONSDATE
A.M. P.M.. Include medication and treatment when Indicated
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t't U.S. GOVERNMENT PRINTING OFFICE = 1983 0 - 421-526 (9201) NURSING NOTES Standard Form MO
(Reverse)
MEDCOM - 5236
30
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,,,,,..,_

DOD 12448

NURSING NOTES
CLINICAL RECORD (Sign all nodes)
HOUR OBSERVATIONS
DATE I.
Include medication and treatment when indicated ' . ... i i ¦ & 0 ,
AM P.M
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REGISTER NO. i
middle; giede; data; hospital or medical facility)
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InteFrandorrAtte on Mcetr.1 199eris 510-109
MEDCOM - 5237

DOD 12449

NURSING NOTES
CLINICAL R
(Sign all notes)
HOUR OSSERVATIONS --
DATE
Include medication and treatment when indicated
A.M. P.M.
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PATIENT'S IDENTIFICATION
(For typed or written entries give: Name—lait, first, . ' REGISTER NO. ' WARD NO. middle; grade; date; hospital or medical facility) 1
;0(6)-4
NURSFIG NOTES Standard Form 510
General Services Administration and Interagency Committee en Medical Records ma /01-11.805-8—Detaber 1975
-.- ..._
MEDCOM - 5238
DOD 12450

NURSING NOTES
(Sign all notes)
DATE HOUR A.M. P.M.. OBSERVATIONS Include medication and treatment when indicated
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* U.S. GOVERNMENT PRINTING NURSING NOTES
OFFICE = 1983 0 - 421-526 19201)
Standard Form 610
(Reverse)
MEDCOM - 5239
DOD 12451
NURSING NOTES
(Sign all notes)
DATE HOUR OBSERVATIONS
A.M. P.M.. Include medication and treatment when indicotad

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* U . S . GOVERNMENT PRINTING OFFICE = 1983 0 - 421-526 (9201) NURSING NOTES
Standard Form 6•
(Reverse)
MEDCOM - 5240

DOD 12452

PATIENT PROFILE
NAVMED 6550/12 (5-80) S/N 0105-LF-60
DATE DATE V VITAL SIGNS FRED SPECIAL NOTES
ACTIVITY DATE B, BATH DIET J
Dentures

Bedrest g Bed bath NPO
=MNShower =MI

Speech impediment
=MI
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Prosthetic device
II Needs assistance
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Blind
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Contact lenses
Mil II
GlaMes
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ORAL HYGIENE
FEEDING DATE FLUIDS Hearing defect
CEINIMEIMIIII Self
• weds assistance Self Forced to: Other
ardelliERINIGnil
r
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Gavage I & 0 Mill
DATE DATE DATE DATE TREATMENTS/SPECIAL NOTES TIMES
RENEW 11=1:1=11 TIMES O -D. RENEW
ORD.
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FINDINGS:
VSI
RELIGIOUS RITES
MEDCOM -5241
DOD 12453

PATIENT PROFILE
NAVMED 6550/12 (5.80) S/N 0105-LF-LUQ-5560

V ACTIVITY DATE st ¦ ATH DATE DIET DATE Nj VITAL SIGNS FRED N/ SPECIAL NOTES
Bedrest Bed bath NPO Temp Dentures Bathroom Privileges Shower REG 4114 Pulse (S Speech Impediment
•4, Up in chair 1411 0 Tub Rasp Language barrier Ambulate Need. existence B/P Proithetic device Commode Othertliv Visual Impairment
`, Needs assistance 14114 Blind
Restricted to unit

Contact lenses Hospital Privileges ORAL HYGIENE DATE Glasses
Other Self FEEDING DATE FLUIDS Hearing d feet Needs aulstance Self Forced to: Other
Y, "NOFI) I et. 41i0 Special Needs assistance Restricted to: Gavage ISO QS
ATE DATE DATE DATE
TREATMENTS/SPECIAL NOTES TIMES TREATMENTS/SPECIAL NOTES TIMES
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OP/SPECIAL PROCE URE A S 51P licklusi6 I¦AUK Ito Rot) -nsIA X 2- ' SI DATE ON DATE OFF
FINDINGS. VSI
iiim-w,t-u¦ A enAn RELIGIOUS RITES

DOD 12454

PATIENT PROFILE
NAVMED 6550/12 (5-60) S/N 0105 -LF-
vl ACTIVITY DATE .,./ BATH DATE DIET DATE Ni VITAL SIGNS FREQ .,il SPECIAL NOTES
Bedrest Bed beth NPO Temp L1/4 1410) Dentures 1-
fu Privileges Shower Pulse i 1 I 1\ S peach Impediment Lip in chair qfi,..1, Tub 4_ 14 Reap 1C-V k CNLk .,. Language barrier
Kil 0
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Commode Other / Visual Impairment Needs assistance , Blind Restricted to unit Contact lenses
Hospital Privileges ORAL HYGIENE • ATE 7 Vil . Glasses
if,3\11 Vo/
Other i Self FEEDING DATE FLUIDS Hearing defect
. 0 C.-t Needs assistance Self Forced to: other

.IC[ 'I, Special I Needs assistance Restricted to:
Gave°. I & 0
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DATE DATE DATE DATE
TREATMENTS/SPECIAL NOTES TIMES TREATMENTS/SPECIAL NOTES TIMES
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RELIGIOUS RITES
MEDCOM - 5243
DOD 12455

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MEDCOM - 5244
DOD 12456

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MEDCOM - 5245
DOD 12457