Medical Report: Medical Records of Various Enemy Prisoners of War and Detainees, Baghdad, Iraq, June 2003

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CHRON.OLOGICAL RECORD OF MEDICAL CARE ' .. ';\ Medical Record
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STANDARD FORM 600 (REV. 8-97)SSN: Prescribed by GSA/leMR
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UNIT AND UNIT PHONE: DOB: 7 '~J 7'&'
MEDCOM -6121
DOD 15218

AUTHOR ED FOR LOCAL REPRODUcnoN
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DOD 15219

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DOD 15220

AUTHORIZED FOR LOCAL REPRODUCTION
MEDICAL RECORD PROGRESS NOTES

NOTES
DATE

DEPART ./SERVICE HOSPITAL OR MEDICAL FACIUTY RECORDS MAINTAINED AT
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DOD 15221

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STANDARD FORM 509 (REV. 5"9991 Prescribed bv GSAJICMR FPMR 14'CFRI 101-' 1.203tblC'Ol
MEDCOM -6124
LAST NAME FIRST NAME

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MEDCOM -6125
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DOD 15222
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HOSPITAL OR MEDICAL FACIUTY

DEPART ./sERVICE RECORDS MAINTAINED AT
SSNIID NO.
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DOD 15225

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HEALTH RECORD CHRONOLOGICAL RECORD OF MEDICAL CARE

CHRONOLOGICAL RECORD OF MEDICAL CARE
MEDCOM -6129
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/Sse Instructionson Back ofthis Shtlflrl

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7. POSITION AND. POSITIONAL AIDS (Specify) ~UPINE D UTHOTOMY 0 PRONE o KRASKE LATERAL~ o LEFT SIDE UP o RIGHT SIDE UP
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REPORT CWEN: I 1 V. I 1 No
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. CLINICAL. RECORD -DOCTOR'S ORDERS'
For use of this form, see AR 40-66; the proponent agency is OTSG
THE DOCTOR SHALL RECORO DATE, TIME AND SIGN EACH SET OF ORDERS. IF PROBLEM ORIENTED MEDICAL RECORD SYSTEM IS USED. WRITE ~OBLEM NUMBER IN COLUMN INDICATED BY ARROW BELOW.

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DA FORM 3841. MAY 79
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