Administration of Fixed Hospitals : Zone of Interior

[Administration of Fixed Hospitals : Zone of Interior]
[From the U.S. Government Publishing Office, www.gpo.gov]

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WAR DEPARTMENT TECHNICAL MANUAL
ADMINISTRATION
• OF FIXED HOSPITALS
ZONE OF INTERIOR
WAR DEPARTMENT • FEBRUARY 1945
NON-CIRCULATING
WA R
DEPARTMENT TECHNICAL MANUAL
T M 8-262
ADMINISTRATION
OF FIXED HOSPITALS
ZONE OF INTERIOR
W A R
DEPARTMENT • FEBRUARY 19 4 5
United States Government Printing Office Washington : 1945
WAR DEPARTMENT Washington 25, D. C, 1 February 1945
TM 8-262, Administration of Fixed Hospitals, Zone of Interior, is published for the information and guidance of all concerned.
[AG 300.7 (25 Jan 45)]
BY ORDER OF THE SECRETARY OF WAR:
G. C MARSHALL
Chief of Staff
OFFICIAL:
J. A. ULIO
Major General
The Adjutant General
DISTRIBUTION:
AAF (2),. AGF (2),- ASF (2); S Div ASF (1),. SvC (Surg) (2),- Dep 8 (2); Army Med Purchasing O (2),- Med Dep Repl Pools (5),- T/O & E 8-650 (1).
Refer to FM 21 -6 for explanation of distribution formula.
I FEB 1945
TM 8-262
FOREWORD
I. PURPOSE OF TECHNICAL MANUAL 8-262, ADMINISTRATION OF FIXED HOSPITALS, ZONE OF INTERIOR.
a. To provide a ready source of reference for all the major procedures connected with the administration of Army hospitals in the Zone of the Interior.
b. To simplify the basic administrative procedures of the nonprofessional care of sick and wounded personnel.
c. To standardize these basic procedures, wherever practicable, by using the same forms and methods at all medical installations.
d. To reduce to a minimum the time required by professionally trained personnel to accomplish the various procedures outlined herein, thereby making available to the sick and wounded an increased amount of professional care.
2. SCOPE.
a. The procedures outlined herein are applicable to named general hospitals within the continental United States.
b. Those procedures which can be used without change in station and other hospitals will be put into practice without delay.
c. From time to time chapters or sections will be published prescribing procedures to be used in a limited number of hospitals. An example of such a procedure is the mechanical reproduction of hospital admission records described in Section 2, Chapter II, which is limited to those hospitals having ten or more admissions a day. When a procedure is thus limited, such limitation will be announced at the beginning of the chapter or section describing it.
3. FORMAT.
a. Technical Manual 8-262 will not initially be published in its entirety. It will be published in chapters or sections as the procedures contained in these parts are tested, approved, and ready to be put into operation in the field. The chapters will not necessarily be published consecutively, but will be issued in the order of their importance to the using installations.
b. In order that the information contained in this manual may be kept current, it is published in loose-leaf form, and revisions or changes will be furnished as required. Changes will be supplied on a page basis. As change pages are received, they will be inserted in their proper place. Each page bears a date in its upper inside corner. This date is the date of publication. Change pages will carry the date and the number of the change.
iii
TM 8-262
I FEB 1945
FOREWORD (CONT'D)
c. The subject matter is grouped into chapters under a primary subject title with a base number and then subdivided into sections with specific titles.
d. Each chapter will be numbered consecutively using the decimal numbering system! for example, the second chapter bears the base number 2.0. Each page within a chapter will be numbered consecutively in relation to the chapter number. Page 2.1 represents the first page of the subject matter of the second chapter, page 2.2, the second page, and so on. If new pages are added within the chapters, the added page will carry an alphabetical suffix: "A," "B," "C," etc. For example, if a new page is added between 2.13 and 2.14, the page will be numbered 2.I3A. A second additional page in the same place would be numbered 2.I3B.
e. Paragraphs are numbered consecutively within each chapter. If new main paragraphs are added, each will carry a decimal suffix. For example, a paragraph numbered 13.1 will represent the first addition to the main paragraph 13.
f. This manual contains descriptive text, diagrams, illustrations and procedure charts. The procedure charts illustrate graphically the flow of records and the action taken on them throughout each step in the process. Two types of rectangular blocks are used in the charts. The first type with shading along the lower and right hand edges of the block indicates document or paper record, for an example, see Figure I below. A block with light shading over the entire face. Figure 2, represents something other than a paper record, such as an action, a telephone call, or a verbal request or notification.
12
LOCATOR CARD
FIGURE 1
NOTIFICATION OF DISCHARGE
FIGURE 2
The numerals appearing in the upper left hand corners of the blocks are the copy numbers, which do not necessarily appear on the forms themselves. Number I indicates the original copy, number 2, the duplicate, and so forth. Row lines are in solid color. A broken flow line represents an alternative action.
g. A complete index and glossary will be issued later as parts of this manual.
4. Comments on any aspect of the subject matter presented herein or suggestions for further simplification and improvement of the procedures and consolidation or elimination of any of the forms are desired from installations. Such comments should be directed through channels to The Surgeon General, attention Control Division, 1818 H Street, NW, Washington 25. D. C.
iv
I FEB 1945 TM 8-262
CHAPTER II
CONTENTS
CHAPTER II HOSPITAL ADMISSIONS
SECTION I PROCEDURE FOR HOSPITAL ADMISSIONS
Responsibility______________________________________________________________ 2.1
Classes of Patients Entitled to Admission _____________________________ 2.1
Arrival of Patients ___________________________________________ 2.1
Initial Assignment of Patients__________________________________________________ 2.2
Treatment and Examination of Patients_______________________________ 2.2
Procedure on Admission of Certain Types of Patients_____________________________ 2.3
Funds, Valuables, Clothing and Baggage in Possession of Patients on Admission 2.3
SECTION 2 PREPARATION OF HOSPITAL ADMISSION RECORDS
Procedures for Preparation of Records.................. ......................... 2.4
Admission Records_______________________________________________________________ 2.4
Preparation and Distribution of Hospital Admission Records Chart________________ 2.6-2.7
Responsibility for Preparation of WD MD Form 55A, Revised_______________________ 2.8
Method of Recording Data on WD MD Form 55A, Revised............................... 2.8
WD MD Form 55A, Revised—Illustration _____________________________________ 2.9
Entries on WD MD Form 55A, Revised—Illustration _. ............................. 2.10-2.14
WD MD Form 55A, Revised—Preparation for Typing—Illustration_____________________ 2.15-2.16
WD MD Form 55A, Revised—Preparation for Mimeographing—Illustration______________ 2.17
Medical Report Card, WD AGO Form 8-24—Illustration______________________________ 2.18
Locator Card—Illustration..................................................... 2.18
SECTION 3 PROCEDURE FOR PREPARING THE ADMISSION AND DISPOSITION SHEET
Definition................................................................ 2.19
Responsibility ........................................................... 2.19
Contents............................................................ 2.19
Preparation and Distribution of Admission and Disposition Sheet—Chart___________ 2.20-2.21
Admission and Disposition Sheet—Illustration ............................ 2.22-2.23
Sources of Data for the Admission and Disposition Sheet—Illustration........... 2.24-2.25
v
TM 8-262
CHAPTER II
I FEB 1945
CHAPTER II HOSPITAL ADMISSIONS
SECTION 1
PROCEDURE FOR HOSPITAL ADMISSIONS
I. RESPONSIBILITY.
a. The Admitting Officer will have charge of the admission to the hospital and the assignment to the proper ward of all patients arriving during regular duty hours. In his absence, his duties will be assumed by his assistant, where one has been designated by the Commanding Officer, or by the Medical Officer of the Day. He will maintain close contact with the Chiefs of the Professional Services to insure that proper assignment of patients to wards is being made.
b. The Admitting Officer will be concerned primarily with professional duties only, such as classification and assignment of patients, while the Registrar will assume responsibility for all administrative functions.
2. CLASSES OF PATIENTS ENTITLED TO ADMISSION. Those persons enumerated in paragraph 6, AR 40-590, and such others as may be authorized from time to time by competent authority will be admitted to the hospital. In the matter of admission of individuals other than those in active military service, the policy of the Commanding Officer will apply.
3. ARRIVAL OF PATIENTS. Immediately upon receipt of information as to the expected arrival of patients by train, the Registrar, or, in his absence, his designated assistant, will arrange for the necessary motor transportation and attendants to meet them. When it is known that patients who are to arrive are suffering from communicable diseases, such separate ambulances as may be required, consistent with good medical policy, will be provided for their transportation. Litter cases, the insane, and prisoners will be met by an adequate number of trained litter bearers, neuropsychiatric attendants, or armed guards, as the case may be. The Commanding Officer, Detachment Medical Department, or the Provost Marshal, or both, depending upon the nature of the patients arriving, will furnish the necessary attendants. When indicated, the Registrar will arrange with the Medical Supply Officer to make the necessary exchange of linen and hospital clothing. The Admitting Officer will make necessary arrangements to effect proper ward assignments without delay upon their arrival at the hospital and will call upon the Chiefs of the Professional Services for such assistance as he may require. The Registrar will provide any additional clerical personnel required for short periods from his office.
*7* ™ 2J
MSRARY ,
TM 8-262
CHAPTER II
I FEB 1945
4. INITIAL ASSIGNMENT OF PATIENTS.
a. All patients will be admitted through the Admitting Office where the required admission data will be made a matter of record, and assignment to the proper ward effected. In emergency cases, the patient may be taken directly to the ward and the necessary admission data obtained there, but in any case, no patient shall be taken to any ward without specific instructions from the Admitting Officer or, in his absence, his assistant or the Medical Officer of the Day.
b. The Consolidated Ward Morning Report will be used as a guide to assist the Admitting Officer in making proper ward assignments and to obviate interward transfers shortly after admission. The Chiefs of Professional Services will notify the Admitting Officer promptly of changes in the character of cases treated on any ward in order that assignments to such wards may be made correctly at all times. In addition, the Chiefs of the Professional Services will furnish any other necessary information and assistance to the Admitting Officer in the discharge of his duties. Wards will accept without question patients admitted thereto, and any reassignment that may be necessary will be effected as prescribed elsewhere in this manual.
5. TREATMENT AND EXAMINATION OF PATIENTS.
a. The Admitting Officer will normally provide a minimum of medical or surgical treatment. Such treatment will be limited to acute emergencies and will be provided by the Admitting Officer to relieve suffering while awaiting the arrival of the proper ward officer, or to permit the safe transfer of the patient to the ward to which he has been assigned. A report of such treatment will be written on the reverse side of WD MD Form 55A, Revised, and submitted to the ward officer without delay for his information and guidance.
b. On admission of patients other than emergency cases or those enumerated in paragraph 6, below, the Admitting Officer will take such medical history and perform such physical examination as will permit assignment of the patient to the proper ward without delay. Every precaution will be taken to insure the proper handling of patients with contagious diseases, acute medical or surgical emergencies, mental conditions, or those under courts-martial charges or sentence, and prisoners of war.
c. Each patient, other than those on an officer status, or where the procedure is otherwise contraindicated, will be required, following the physical examination, and upon order of the Admitting Officer, to divest himself of his clothing and take a shower bath, following which he will don hospital clothing and be escorted without delay to his proper ward by personnel assigned to the Admitting Office. Where the Admitting Office is not provided with facilities for shower baths, this shall be done promptly at arrival upon the ward where the prqcedure will be ordered by the ward officer. Every care shall be taken to protect the privacy of male as well as female patients.
2.2
rrn .A.r TM 8-262
1 FEB l94B CHAPTER II
6. PROCEDURE ON ADMISSION OF CERTAIN TYPES OF PATIENTS.
a. Patients with Communicable Diseases. If 'the presence of the condition is known in advance, such patients will not be permitted to leave the ambulance or enter the Admitting Office, but after examination by the Admitting Officer, will be sent directly to the appropriate isolation ward. Should such a patient be admitted inadvertently to the Admitting Office, the medical officer in charge of communicable diseases will be notified and will issue appropriate instructions.
b. Insane Patients. Insane patients will be escorted without delay to the receiving unit of the neuropsychiatric section, accompanied, whenever possible, by a trained neuropsychiatric attendant.
c. Medical or Surgical Emergencies. These will not be removed from the ambulance until so directed by the Admitting Officer in order to avoid unnecessary handling. Such cases will be given prompt attention as soon as they arrive. If practicable, they will be delivered by ambulance directly to their proper ward, the x-ray department, or the operating room, as the case may be. To reduce transporting and handling of such cases to a minimum, the appropriate Chief of Service or his designated representative will hold himself available to offer necessary advice and assistance to the Admitting Officer so that appropriate ward assignment can be made or necessary treatment instituted without delay. The x-ray unit, the operating room, or the ward receiving the patient, as the case may be, will be notified by telephone by the Admitting Officer at the earliest possible moment whenever medical or surgical emergencies are admitted.
d. Prisoners. They will be accompanied by guards, when indicated, to their proper ward. When the nature of the offense is such that it can be accomplished without defeating the ends of military justice, paroles may be accepted from garrison prisoners in order that the giving of medical care may be facilitated and the waste of personnel occasioned by the use of armed guards may be avoided. The Commanding Officer, Detachment of Patients, and the Provost Marshal will be notified by telephone of the admission of prisoner?.
e. Prisoners of War. The same procedures, except for the taking of paroles, wilt apply in the case of prisoners of war admitted as patients. The Provost Marshal will be notified at the earliest possible moment in order that necessary guards and facilities for safekeeping of such individuals may be provided.
7. FUNDS, VALUABLES, CLOTHING, AND BAGGAGE IN POSSESSION OF PATIENTS UPON ADMISSION. Upon admission of a patient to the hospital, the procedure relative to funds, valuables, clothing, and baggage will be followed as prescribed elsewhere. When insane or seriously ill patients or prisoners are admitted, they will be searched, their effects secured, and the proper records made. When the patient is unable or mentally incompetent to sign, the forms will be signed for him, in the presence of a witness, by an individual authorized to do so by the Commanding Officer. The effects will then be stored in the Patients’ Baggage Room, or in the Patients' Funds and Valuables Depository, whichever is appropriate.
2.3
TM 8-262
CHAPTER II I FEB 1945
SECTION 2
PREPARATION OF HOSPITAL ADMISSION RECORDS
8. PROCEDURES FOR PREPARATION OF RECORDS. The mechanical reproduction of records described in this section is authorized for all hospitals having an average admission rate of ten or more per day. Hospitals having fewer than this number of admissions will be authorized the new procedure only after the Service Commander having jurisdiction over the hospital establishes by survey that a definite saving in personnel will result from its use. Hospitals not authorized the mechanical method of reproduction of records will prepare the records outlined in paragraph 9, with the following variations:
a. WD AGO Form 8-33, in duplicate, will be prepared in place of WD MD Form 55A, Revised. The original will be forwarded to the ward with the patient and the duplicate to the Registrar.
b. WD AGO Form 8-24 will be prepared in the necessary number of copies from the duplicate copy of WD AGO Form 8-33.
c. 3 x 5 inch Locator Cards will be prepared by the using agency from data appearing on the Admission and Disposition Sheet.
9. ADMISSION RECORDS. The following records will be prepared in the Admitting Office under the direction of the Registrar who will assume responsibility for their completeness and accuracy. Any additional records are unnecessary and will be neither prepared nor maintained unless specifically authorized elsewhere in this manual.
a. To be prepared for each patient at the time of admission:
(I) Clinical Record Brief, WD MD Form 55A, Revised, prepared as a stencil and permanent record in one operation. The backing sheet, or permanent record, is forwarded to the ward with the patient. The stencil is used to prepare locator cards, WD AGO Forms 8-24, and other admission records mechanically on a Mimeograph duplicator supplied expressly for this purpose.
(2) Locator Cards, prepared in as many copies as required and distributed as indicated on pages 2.6 and 2.7.
(3) WD AGO Form 8-24, prepared in two or three copies, as required, and forwarded to the Office of the Registrar.
(4) Deposit Slips, to be prepared in two or three copies when funds are deposited, and in one copy when the patient does not desire to make any deposit. The detailed procedure will be described elsewhere in this manual.
2.4
1 FEB ”45 CHAPTER II
(5) Patients Clothing Slip, WD AGO Form 8-1 I I, prepared in two copies, showing inventory of clothing stored by patient. Original is forwarded to clothing room with clothing, and duplicate is delivered to patient as his receipt. When clothing is stored on the ward, these slips will be filled out by the nurse.
(6) Property Tag, WD MD Form 76, prepared for each piece of baggage stored by the patient. One part is tied to the baggage, and the remaining section delivered to the patient as his receipt.
b. To be prepared daily:
(I) Admission and Disposition Sheet. This constitutes a record of all admissions to and dispositions from the hospital; all leaves, furloughs, absences, and interward transfers are recorded on it. It is prepared at 2400 hours daily as described elsewhere in this manual.
(2) Consolidated Ward Morning Report prepared at 2400 hours daily. Its preparation and distribution are described elsewhere in this manual.
c. To be maintained on a permanent basis and brought up to date daily:
(I) Suspense Files, maintained in the Admitting Office:
(a) Leaves for officer personnel.
(b) Furloughs for enlisted personnel.
(c) Passes for enlisted personnel. These files are made up of Absence Requests, filed according to the date the individual is due to return. Details as-to their use will be found in the section dealing with Passes, Furloughs, and Leaves.
(d) Clinical records. Upon departure on leave or furlough, the clinical record of such a patient will be brought up to date by the ward officer and forwarded to the Admitting Office pending the patient's return. The same procedure will be followed in the event of any absence without official leave of more than twenty-four hours duration.
(2) Locator File for Admitting Office, showing the location of every patient in the hospital.
(3) Register Number Index. 3x5 inch cards, filed serially by register number, will be maintained as a permanent record.
2.5
TM 8-262
CHAPTER II
I FEB 1945
PREPARATION AND DISTRIBUTION OF
DOCUMENT ADMITTING CLERK PATIENT WARD NURSE
CLINICAL RECORD BRIEF, WD MD FORM 55A, REVISED, WITH STENCIL
WD MD FORM 55 SERIES
WD MD 55A
STENCIL WD MD 55A
—Prepares WD MD 55A and stencil in one operation on the typewriter from information obtained from the patient or his records or both.
STENCIL WD MD 55A
WD MD 55A
WD MD 55A
Ward
Officer
—Receives for delivery to Ward Nurse.
—Uses to prepare necessary forms of WD MD 55 Series.
WD MD 55 SERIES
WD MD 55 SERIES
WD MD 55 SERIES
WD MD 55 SERIES
WD MD 55 SERIES
WD MD 55 SERIES
Ward
Officer
—Uses to prepare Locator Cards and WD AGO Forms 8-24.
—Leaves stencil in place on duplicating machine for preparation of associated admission records.
—Prepares as the case requires.
17 LOCATOR CARD
16 LOCATOR CARD
15 LOCATOR CARD
14 LOCATOR CARD
LOCATOR CARDS (3 x 5 INCHES)
MEDICAL REPORT CARD WD AGO FORM 8-24
13 LOCATOR CARD
12 LOCATOR CARD
10 LOCATOR CARD |
12 LOCATOR CARD
LOCATOR CARD
LOCATOR CARD
—Receives for delivery to ward nurse.
—Prepares number of Locator Cards needed from stencil of WD MD 55A, at time of admission.
—Gives patient cards Number I and 2 for delivery to ward nurse. See Note I.
9 LOCATOR CARD
8 LOCATOR CARD
7 LOCATOR CARD^fll
I, 6 LOCATOR CARD | ■ 15 LOCATOR CARD
2 LOCATOR CARD
2 LOCATOR CARD |
LOCATOR CARD
—Uses copy I for bedside card. Where holders are of smaller capacity than 3x5 inches, card will be cut to fit.
—Uses copy 2 for ward roster system.
ness on day following admission of patient.
See Note 2.
WD AGO 8-24
—Prepares WD AGO 8-24 from stencil of WD MD 55A. (2 copies only are normally required. The third copy will be prepared as an Evacuee Card when needed.)
WD AGO 8-24 | >| 2 WD AGO 8-24|
2.6
I FEB 1945
HOSPITAL ADMISSION RECORDS
TM 8-262
CHAPTER II
REGISTRAR
INFORMATION OFFICE DETACHMENT OF PATIENTS
OTHER INTERESTED AGENCIES
NOTE I. Patients will not be held unduly in the Admitting Office awaiting the preparation of their Locator Cards. When large convoys of patients are admitted, each individual will be retained only long enough to have WD MD Form 55A prepared with stencil. He will then be sent to the ward with the form. After all of the convoy have been sent to their assigned wards, the stencils will be affixed to the duplicator and the Locator Cards run off and distributed as soon as possible. NOTE 2. The actual distribution of the Locator Cards will vary with each medical facility. For this reason each installation using this method will conduct a survey to determine which agencies require cards. In general, any agency requiring any part of the information presented on the cards will use them, either disregarding the additional data, or adding its own material. Preparation of new cards, where these will serve, is not authorized. Where 5x8 inch cards are ordinarily used, the files will be changed to accommodate 3x5 inch cards, and when, for any reason, this is not possible, the 3 x 5 inch card can be stapled or clipped to the larger card and inserted in the index.
3
LOCATOR CARD
—Uses in preparing statistical data for MD WD 86ab and then to locator file. Replaces Register Index Card, WD MD 52a, no longer required.
LOCATOR CARD
—Uses for locator file.
5
LOCATOR CARD
—Uses in preparation of Morning Report and then files.
WD AGO 8-24
3 WD AGO 8-24 |||M^SGO (Evacuee Card)
1 -■
—Holds copy I for permanent file after discharge of patient.
—Holds copy 2 for transmittal to the Office of The Surgeon General after final disposition of the patient is made or uses as a Transferred Card when patient is transferred to another hospital.
—Sends copy 3 to the Office of The Surgeon General as Evacuee Card, when indicated.
\1 LOCATOR CARD |
16 LOCATOR CARD |
« 15 LOCATOR CARD |
« 14 LOCATOR CARD |
q 13 LOCATOR CARD|
12 LOCATOR CARD |
। 11 LOCATOR CARD |
« 110 LOCATOR CARD I
q I 9 LOCATOR CARD I
■ |~8 LOCATOR CARp|
■ 7 LOCATOR CARD |
■ p ~ |
L LOCATOR CARD
—Distribution as follows:
Copy Receiving Agency See Note 2. Use
6 Admitting For preparation of Admission
Office and Disposition Sheet, then to locator file.
7 Admitting For register number index to
Office replace register number roster.
8 Mess For preparation of statements
Officer for all patients on a pay status. See paragraph 12, AR 40-590.
9 AAF Liaison Officer For classifying AAF patients.
10 Post Office For locator file.
II Chaplain For locator file.
12 Red Cross For locator file.
13 Provost Marshal When required.
14 Public Relations
Officer When required.
15 Baggage Room When required.
16 Others When required.
2.7
TM 8-262
CHAPTER II I FEB 1945
PREPARATION OF WD MD FORM 55A, REVISED
10. RESPONSIBILITY FOR PREPARATION OF WD MD FORM 55A, REVISED. The preparation of WD MD Form 55A, Revised, is the responsibility of the Registrar. He will take all necessary steps to insure that the personnel working under his direction in the Admitting Office are acquainted with the pertinent sections of AR 40-590 and 40-1025.
II. METHOD OF RECORDING DATA ON WD MD FORM 55A, REVISED.
a. The necessary information is entered by typewriter promptly upon the arrival of the patient at the Admitting Office. The Admitting Office will be so arranged that the patient may be brought directly to the typist who will enter the data without the use of scratch sheets or other temporary records. To avoid delay, additional typists will be provided by the Registrar from his office whenever large numbers of patients are to be processed. Their services will ordinarily be required for short periods only, so that there will be a minimum of interference with the functioning of the Registrar's office. Under such circumstances, the personnel regularly on duty in the Admitting Office will hold themselves available to assist temporary personnel, rather than attempt to do the major portion of the processing themselves.
b. As each patient is called to the typist, all readily available records pertaining to him will be delivered at the same time. If he has already been interviewed by the Admitting Officer, he will present to the typist a slip of paper upon which has been written the number of the ward to which he has been assigned. If he has not yet been interviewed, this space will be left blank on WD MD Form 55A, Revised. In any case, the typist should have available any clinical records, service records, dispensary reference slips, etc., which may have accompanied the patient. Such records will furnish much of the information needed, and the balance will be obtained from the patient himself, who will be required to check all pertinent information to insure its accuracy. The need for accuracy cannot be too strongly stressed. Failure to make entries carefully and accurately will lead to possible errors in identification and will seriously interfere with the proper functioning of the hospital departments.
c. It will be noted that each box on the WD MD Form 55A, Revised, is either lettered or numbered. The form is arranged for a standard typewriter spacing and makes full allowance for the use of stops. Insofar as is feasible, the form is designed to permit the typist to write across its full width with as little break in the continuity of thought as possible.
d. Typewriter stops having been set, the form is aligned in the typewriter and the information entered, using standard abbreviations whenever possible. Whenever the space for any of the entries from I to 10 inclusive is not sufficient to complete an entry, such entry will be continued directly beneath space 10, appropriately cross-referenced, with the first continuation marked (a), the second (b), and so on. Care will be taken to complete all data entered in this space to the right of the dividing line so that the material will appear on WD AGO Form 8-24 when the duplicating process is used. The following pages illustrate WD MD Form 55A with correct entries and give instructions on how to fill them in properly.
2.8
I FEB
1945
TM 8-262
CHAPTER II
WD MD FORM 55A, REVISED, COMPLETED
/ \ CLINICAL RECORD BRIEF 7 X
W. D., M. D. FORM NO. 55A (REVISED)
1 Sept., 1944
(WHEN AUTHORIZED FOR USE THIS FORM REPLACES W. D., A. G. O. FORM NO. 8-33)
12. Id .S' K OK PL' ty Li. TMFilTjsiTKn; sntx DaIx U. 8/^NATUKe or W.UO» t^itOEQR:-
2.9
a. Hosfttal 1. Last Namm, Fust Name, Middle Initial
Blake GH_________________________Doe , John C________________________________
b. Ward c. Religion d. Pret. Adm. 2. Register No. 3. Abmt Sebial No. I 4. Gbade
27 P__________________No 34 278 11 067 928 I Pvt
e. Namb and Address or Nearest Relative S. Organisation and Abm or Sbbvice (if A AF personnel, mc below'*
Mrs Robert Doe (M) 27th Inf Div
78 Wol 1 man ^>t 6. Ac. 7. Race 8. LekctkofSuvice 9. Date or Admission
No Evid of Brookline, Mass 27 W 2 7/12 1 Sep 44
Ale or Narc f tJls- lw B;C «• ApurmncOmcm 10. Soo.ce or»».,.«.«« TrfJ ff, BelVOlr _D_________________________________Capt HAP Va._______________________________________________
* If AAF, indicate pilot, non-pilot flying pcrsonneL ground personnel, or aviation cadet.
11. Final Diagnosis, Additional Diagnoses, Operations, Change or Status
1020
ID Unk
Doe, John C Pvt 27
TM 8-262
CHAPTER II
I FEB 1945
ENTRIES ON WD MD FORM 55A, REVISED
a. Hospital Blake GH 1. Last Namm, Fib*t Namm, Middm"Initial
b. Wabd o. Rbugioh d. Pbbt. Adm. 2. Rbcistbb No. 3. Abmt Sbbial No. 4. Gbadb
"a. Hospital." Enter the name of the hospital to which the patient is now being admitted, as Pasadena RH, Camp Roberts SH, Mitchell CH, or Wakeman G&CH.
b. Wabd 27 c. Religion d. Pbbt. Adm. 2. Rbcwtbb No. S. Abmt Sbbial No. 4. Gbadb
personnel. see below'*
"b. Ward." Enter the number of the ward to which assignment has been made. If this is not known at the time the form is prepared, leave the space blank. The stencil need
not be put back into the typewriter. The number can be entered with a pencil or stylus directly on the stencil.
b. Wabd c. Rbucion P d. Pbbt. Adm. 2. Rbcutkb No. 3. Abmt Sbbial No. 4. Gbadb
o. Namm and Admukss or Nbabbst Relatxvb S. Obganixation and Abm ob Sbbticb (if AAF pcrwnwl, see below'*
"c. Religion." Enter the religious preference of the individual, using the initial
"P" for Protestant, "C" for Catholic, "H" for Hebrew, etc., or "N" when none is claimed.
b. Wabd c. Rbuciom d. Pbbt. Adm. No 2. Rbcistbb No. 3. Abmt Sbbial No. 4. Gbadb
e. Namb add Adosbss or Nbabbst Rblatitb 5. Organization and Abm ob Sbbticb (if AAF personnel, see below'*
"d. Previous Admission." This refers to a previous admission to the hospital
which the patient is now entering. Enter "No" or "Yes" in this space, as the case may be.
©. Namb and Addbbss or Nbabbst Rbaatitb Mrs Robert Doe (M) 78 Wellman St Brookline. Mass 5. Obcanibation and Abm ob Sbbticb (if AAF personnel. aee below'*
6. Acs 7, Rack 8. Length or Sbbticb 9. Date or Admission
L Dm. I Im. I B/Cj g. Admittinc Omen 10. Souses or Admission
"e. Name and Address of Nearest Relative." Use the form required by pos-
tal authorities in addressing mail. |n addition, indicate the relationship of the individual named by means of an appropriate letter, in parentheses, inserted after the name, e.g.:
(M) Mother (S) Sister (H) Husband (U) Uncle
(F) Father (B) Brother (W) Wife (A) Aunt
(C) Cousin (Fr) Friend
(N) Niece or Nephew
J | 1
L Dis. 1NJ. B/C g. Admitting OmcBB 10. Soubcb or Admission
D
If AAF, indicate pilot, non-pilot flying personnel, ground personnel, or aviation cadet.
"f. Disease/Injury/Bat-tle Casualty." This refers to the primary cause of
admission to the hospital. Enter the letter "D," "I," or "B/C" in the appropriate box.
t Dis. Ini. B/C g. Admitting OmcBB 10. Soubcb or Admission
Cant HAP
* If AAF, indicate pilot, non-pilot flying personnel, ground peraonnel, or aviation cadet.
11 ADDmoNAi. Diacnosbs, OrsBATions, Chancb or Statu*
"g. Admitting Officer." Enter the rank and initials of the officer in charge of
the Admitting Office at the time of admission. No written signature is required.
2.10
TM 8-262
CHAPTER II
I FEB 1945
ENTRIES ON WD MD FORM 55A, REVISED (CONT'D)
a. Hospital 1. Last Name, Fib st Name, Middle ^nitulx. Doe, John C
b. Wako c. Rbucior d. Pbev. Adm. 2. Recmter No. 3. Abmt Serial No. 4. Grade
order. If there is no middle initial, no reference to such lack is required.
"I. Last Name, First Name, Middle Initial." Enter the name exactly in this
b. Ward c. Religion d. Prbv. Adm. 2. Rbcisteb No. 34 278 3. Abmt Serial No. 4. Grade
e. Name and Add* ess or Neabest Relative 5. Organization ano Arm or Sebvice (if AAF personnel, see below'*
"2. Register Number." This is a consecutive number assigned to each pa-
tient admitted. No reference to previous register numbers is required.
b. Ward c. Relicion d. Pbev. Adm. 2. Rbcisteb No. 3. Abmt Serial No. -11.067 928 4. Gbadb
e. Name and Adds ess or Nbabest Relative 5. Obganization and Abm ob Sebvice (if AAF personnel, see below'*
"3. Army Serial Number." It is especially important that the patient's
Army Serial Number be correctly typed. Enter the number thus: 33 372 779 or 0 443 972.
b. Wabd c. Religion d. Pbev. Adm. 2. Rbcistbb No. 3. Abmt Serial No. 4. Grade Pvt
©, Name and Addbess or Neabest Relative 5. Obganization and Abm ob Sebvice (if AAF personnel, see below'*
"4. Grade." Record the patient's grade or rank as of the date of admission,
using authorized abbreviations.
1 1 I 1
e. Name ard Address or Nearest Relative 5. Obcarixatior ard Arm or Service (if AAF personnel, see below'* 27th Inf Div
6. Acs 7. Race 8. Length or Service 9. DateovAdmmsior
"5. Organization and Arm or Service." Enter the current arm or service fol-
lowed by the name of the parent organization to which the patient is currently assigned or attached; wherever possible, these two are combined, as in the example. In cases of Women's Army Corps personnel detailed to an arm or service, add the term WAC in parentheses after the designation of the current arm or service. Use authorized abbreviations wherever possible. In the case of AAF personnel, indicate in parentheses after the arm or service whether the individual belongs to ground personnel or to flying personnel; and if in the latter category, indicate the status, i.e., pilot, nonpilot, or aviation cadet. Individuals required to participate frequently and regularly in aerial flights will be considered as flying personnel. The individual concerned will be carefully questioned in every case and, where it is necessary, personnel records will be examined if they are immediately available, to determine current assignment or attachment.
6. Acb 7. Rack 8. Lkncth or Service 9. DateofAdmusior
____________________________________27_____________________________________________
f. Dm. j Irj. J B/C g. Admittirc Officer 10. Source of Admissioh
"6. Age." Enter the patient's age as of his last birthday. Regardless of the length of time the patient may be under treatment or observation, his age on the date of initial admission for this consecutive period of hospitalization will be carried until final disposition of the case.
•41100 0-45-2
2.1 I
TM 8-262
CHAPTER II
I FEB. 1945
ENTRIES ON WD MD FORM 55A, REVISED (CONT’D)
f. Dis. I Inj. I B/C I g. Admitting OrncM
6. Age 7. Race w 8. Length or See vice 9. Date or Admission
10. Souses or Admission
"7. Race." The symbols "W," "N," "F," "PR," "CH." "JP," "MX," or "I"
will be used for designating White, Negro, Filipino, Puerto Rican, Chinese, Japanese, Mexican, or Indian patients, respectively. The race or nationality of other patients will be written out in full.
6. Acs
7. Race 8. Length or Service 9. Dsn or Admission
f. Dis.
Inj.
B/C | g.
Admitting Oiticeb
10. Source or Admission
2 7/12
"8. Length of Service." Compute the length of service from the beginning
of the patient's current uninterrupted active service up to, but exclusive of, the day of initial admis-
sion. Furloughs commonly granted inductees at the time of induction will not be considered as active service. For members of the National Guard, active service refers to the time since induction into Federal Service. The length of service will be recorded to the last completed month, in years and
fractions of years. Thus, 4 years, 5 months, and 24 days of service will be recorded as 4 5/12. If
length of service is less than one month, enter the number of days as a fraction of 365. Thus, 21 days of service will be recorded as 21/365. In the event of a change in the patient's grade during his current uninterrupted active service, such as an enlisted person becoming a commissioned officer or vice versa, record the total current uninterrupted active service as stated above, specifying in parentheses the length of service in the current grade. Thus, in the case of a commissioned officer having 3 years, 6 months, and 25 days of total current uninterrupted active service as an officer and an enlisted man, of which I year, 2 months, and 15 days have been in current grade as a commissioned officer, the length of service will be recorded as 3 6/12 (I 2/12). Any previous active Army service prior to current active service will be recorded separately in the supplemental space, properly cross-referenced, as described in paragraph I Id. Any previous service in any branch of the armed forces except the Army is not counted here.
Inj. | B/C | g. Admitting Otfickr 10. Source or Admission
6. Ace 7. Race 8. Length or Service 9. Date or Admmsion 1 Sep 44
"9. Date of Admission." This represents the date the patient came under the
care of the medical installation. Use authorized abbreviations and enter in the following order: Day,
Month, Year, e.g., 12 Sep 44. Figures will not be used to indicate months.
"10. Source of Admission." Entries in item 10 will be of two basic kinds: direct admissions and admissions by transfer. The medical installation, either hospital or dispensary, where the patient first comes to the attention of a medical officer as "a patient excused from duty," is the only installation which reports him as a direct admission. A patient will be recorded only once as a direct admission during a continuous period of illness. Subsequent admissions to other medical installations during such continuous period of illness will be regarded as admissions by transfer.
_________i________I___________
10. Source or Admission
Direct
* If AAF, indicate pilot, non-pilot flying personnel, ground personnel, or aviation cadet.
f. Dis.
Ini. B/C
g. Admitting OrncKR
Additional. Diagnoses, Operations, Chance or Status
Enter "Direct" when the patient is admitted directly from the command of the
reporting medical installation or from the organizations attached to the command, including those
2.12
TM 8-262
CHAPTER II
I FEB. 1945
ENTRIES ON WD MD FORM 55A, REVISED (CONT'D)
attached for medical care only. In the event that this organization is attached but not located on the post of the reporting medical installation, the location will be specified in item 5, Organization.
I
£. Dis. Ini. B/C g. Admitting Officer 10. SOURCE OF ADHISSIONDirect _ 0^^. sta Ft Belvoir, Va.

* If AAF, indicate pilot, non-pilot flying personnel, ground personnel, or aviation cadet.
11. Final Diagnoms, Additional Diagnoses, Operations, Chance of Status
patient's station when he is a direct admission but does not belong to an
Enter "Direct-Casual" and specify the name and geographic location of the organization which is of the
command or attached to the command of the reporting medical installation.
i
f. Dis. Ini. B/C g. Admitting Officer 10. Source or Admission Direct _ QaSUal. PaSS Prop sta Ft Custer, Mich

• If AAF, indicate pilot, non-pilot flying personnel, ground personnel, or aviation cadet.
11. Final Diagnosis, Additional Diagnoses, Operations, Chance or Status
missions or direct-casual, depending on the location of the proper station, absence.
Patients admitted from leave, furlough, or pass will be recorded as direct ad-State the type of authorized
i i
f. Dis. Ini. B/C g. Admitting Officer 10. Source or Admission Direct _ CaSUal. AW0L Prop sta Ft Jackson. SC

* If AAF, indicate pilot, non-pilot flying personnel, ground personnel, or aviation cadet.
11. Final Diagnosis, Additional Diagnoses, Operations, Chance or Status
Patients admitted from a status of absent without leave are entered as direct
admissions or direct-casual, depending upon the location of the proper station. State the fact of
absence without official leave.
f. Dis. Ini. B/C g. Admitting Officer 1 1 10. Source or Admission Tpf J SH Ft BelVOlr, Va.

• If AAF, indicate pilot, non-pilot flying personnel, ground personnel, or aviation cadet.
11. Final Diagnosis, Additional Diagnoses, Onsiinons, Chance or Status
For all cases received by transfer, enter the designation of the medical installa-
I
f. Dis. Ini. B/C g. Admitting Officer 10. Source or Admission
Trfd fr 150th Evac H.
• If AAF, indicate pilot, non-pilot flying personnel, ground personnel, or aviation cadet.
11. Final Diagnosis, Additional Diagnoses, Operations, Change or Status
tion transferring the patient. Formerly, for successive transfers entry had to be made in item 10 of the designation and geo-
graphic location of the medical installation which initially admitted the patient for the current consecutive period of hospitalization and the date of such initial admission. Such entry is no longer required if the information has been entered on the Field Medical Record, WD MD Form 52b, c, or d, or one of the Transferred Cards, WD AGO Form 8-24, received with the patient by the receiving
hospital. It is the responsibility of the Registrar to check the records prior to the discharge of the patient to insure that such entry exists on one of these forms. If it is not already present, it will be entered on both The Surgeon General's copy and the hospital file copy of the WD AGO Form 8-24 before the patient is discharged.
. ..... ... . . .. .. . ..... • ।
f. Dis. Ini. B/C g. Admitting Officer 10. Source or Admission Adm gR gu
Ft Geo G Meade, Md,
• If AAF, indicate pilot, non-pilot flying personnel, ground personnel, or aviation cadet.
11. Final Diagnosis, Additional Diagnoses, Operations, Chance or Status
Patients admitted from sick leave or convalescent furloughs granted by a
medical installation will be regarded as admissions by transfer. Record the fact of leave or furlough
2.13
TM 8-262
CHAPTER II
I FEB 1945
ENTRIES ON WD MD FORM 55A, REVISED (CONT'D)
together with the name and location of the medical installation which granted it. Patients admitted from sick leave or furlough not granted by a medical installation will be considered as direct
L Dis. Ini. B/C g. Admitting Officer
10. Source of Admission
Admitted fr outpatient fr CRO
If AAF, indicate pilot, non-pilot flying personnel, ground personnel, or aviation cadet.
admissions.
A patient changing from an out-patient status, carded for record only, will be
regarded as an admission by transfer provided that he was carded for record only because of his current condition. An admission from an out-patient status not carded for record only will be regarded as a direct admission.
Tbc
No Evid of Ale or Narc
e. Name and Address or Nearest Relative 5. Organization ano A«m o» Si
6. Acs 7. Race 8. Lenct
f. Dis. | Ini. | B/C I g. Admitting Officer 10. Soubcb of Admission
Enter the cause of admission on the left side of the box opposite the second line of typing in space "e," in as brief a form as possible. Include statement
as to the patient s sobriety and any indication of the use of narcotics. The entry is required for the use of the investigating officer under the provision of AR 345-415 and 600-550.
| * tf AAF, indicate pilot, non-pilot flying personnel, ground personnel, or aviation cadet. |
11. Final Diagnosis, Additional Diagnoses, Operations, Chance of Status
1020
LD Unk
Doe, John C Pvt 27
12. Line or Duty 13. Disposition and Date 14. Signature or Ward Surgeon
W—40778-1 rir U s. GOVUHMCHT FRINTIN6 OFFKC I IM4
"II. Final Diagnosis, Additional Diagnoses, Operations, Change of Status," "12. Line of Duty," " 13. Disposition and Date," "14. Signature of Ward Surgeon." Items II, 12, 13, and 14 are, as is apparent from their titles, not filled in at the time of admission. They are completed by the Ward Officer at the time of disposition of the patient.
However, for every patient admitted, remarks are entered immediately under
item I I as shown in the example. Enter first the exact hour of admission. Directly beneath the hour of admission enter the line of duty status. On the third line enter any pertinent remarks which clarify
the status of the patient, that is, whether he is an applicant for the United States Military Academy, an applicant for enlistment, or such miscellaneous remarks which may be required for administrative reasons and which do not appear elsewhere on the form. The name, grade or rank, and age of the patient are repeated directly above the line drawn on the stencil for visible card file systems when
they are used. The information outlined in this paragraph and illustrated in the example will not appear on the Clinical Record Brief due to the arrangement of the carbon paper. It is entered here
so that in the mimeographing process it can appear on the Locator Cards, which are the only other forms on which it is required.
2.14
TM 8-262
CHAPTER II
I FEB 1945
WD MD FORM 55A. REVISED PREPARATION FOR TYPING
INSTRUCTIONS FOR TYPING PREPARATION
The revised form of WD MD Form 55A, illustrated above, has been designed to expedite the preparation of a patient's admission records. The form consists of two parts, a white stencil and a backing sheet which will be used as the Clinical Record Brief. The material printed on the stencil has been prepared so as to register exactly with the facsimile printed on the backing sheet.
The special carbon paper which is provided with each quire of stencils at the ratio of one carbon to every two stencils, is coated completely on one side and for a distance of only two and one-quarter inches on the other.
2.15
TM 8-262
CHAPTER II
I FEB 1945
WD MD FORM 55A_ REVISED PREPARATION FOR TYPING (CONT'D)
I
INSTRUCTIONS FOR TYPING PREPARATION (CONT'D)
The carbon paper is inserted between the stencil and the backing sheet of WD MD Form 55A, so that the short-coated side is against the backing sheet at the top, as shown in the illustration above.
The stencil assembly with carbon inserted is put into the typewriter and aligned in the usual way. The ribbon indicator is set at "stencil" position and the form is now ready for the completion of the entries. Best results are obtained when the entries are typed approximately I/32nd of an inch above the line.
2.16
TM 8-262
CHAPTER II
I FEB 1945
WD MD FORM 55A, REVISED PREPARATION FOR MIMEOGRAPHING
/ I * lb-
A _ M cuHiCM. XtCOX'.> W’1'3' 9
fc r fl Os “ wp «?^BO55A
'>'^4 ___________________I
eOSK UIPLA^8 * 0~ -------- Ife
————"-n
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0 rrrr^7^I rrr^—I, Pvt 4 W
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'-• ^M»«mma>‘‘’* ■ —4
'*■* *.i> »«*> *» *s* TT #***" ' I* '^^9R I ~ —p7*T*~T~ >’»«>“♦*<4>,<> I ...-j. '.-, f ,,._ u ,t »ri> >rir>**I
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I ... | I
■ ;4j<«v»ir <«* *O Thc I - ( ;. yXt ' _J
« n Total I Hospital Quarters
VI V2~
16. Name and Location of Reporting Installation
W1 W2
17. Signature
W.D..A.G.O.
FORM NO. 8-24
_____________________________________________________________ 1 July 1944
(This form supersedes W. D. M. D. Form No. 52,
which will not be used after receipt of this revision.) 16-40864-1 ☆ gpo
INSTRUCTIONS FOR REPRODUCTION
The Medical Report Cards, WD AGO Forms 8-24, and Locator Cards together with associated forms which are described elsewhere in this manual, are prepared mechanically by means of the stencil assembly of WD MD Form 55A, Revised, and a Model 90 Mimeograph duplicator furnished exclusively for this purpose. Detailed instructions as to its adjustment and use are supplied with each machine.
The required number of Medical Report Cards is prepared by feeding blank cards into the machine using the right hand feed guide.
The required number of 3 x 5 inch Locator Cards is prepared by feeding the blank cards into the machine using the left hand feed quide.
The forms to be used should be arranged in stacks of the proper number and in the proper order to facilitate their reproduction. A short period of time should be allowed after reproduction to let the ink dry. Then the cards may be sorted for distribution.
LOCATOR CARD
Blake GH Doe, John C ‘
27 P No 34 2?8 11 067 928 Pvt
Mrs Robert Doe (M) 2?th Inf Div
78 Wellman St
Brookline, Mass 27 W 2 7/12 1 Sep /,/, I
Trfd, SH Ft Belvoir,
D Capt HAP Va.
1020 LD Unk
Doe, John C Pvt 27
2.18
TM 8-262
CHAPTER II
I FEB 1945
SECTION 3
PROCEDURE FOR PREPARING THE ADMISSION AND DISPOSITION SHEET
12. DEFINITION. The Admission and Disposition Sheet is a consolidated report of all patients admitted to and discharged from the hospital, quarters, and convalescent facilities, interward transfers, and corrections or changes of previous entries.
13. RESPONSIBILITY. Although the Admission and Disposition Sheet is prepared by personnel on duty in the Admitting Office between 0001 and 0700 hours of the day following the 24 hour period to be covered, the Registrar is responsible for its preparation. His signature, or the signature of an individual delegated that responsibility, will appear at the bottom of the last page. He will also see that the proper number of copies is printed and that proper distribution is made.
14. CONTENTS. Entries on the Admission and Disposition Sheet will be grouped in order by (a) admissions, (b) change of status in, (c) dispositions, (d) change of status out, (e) interward transfers, and (f) corrections of entries previously made. The arrangement of data is shown on pages 2.22 and 2.23. Patients returned from overseas whose names appear as admissions or dispositions will be indicated with an asterisk (*). Except for corrections, only information pertaining to the 24 hour period ending at 2400 hours will be entered. The use of "as of" entries will be held to a minimum, and the Registrar will undertake at regular intervals a study of such entries with a view towards fixing the responsibility for their appearance on the sheet and eliminating them.
2.19
TM 8-262
CHAPTER II
I FEB 1945
PREPARATION AND DISTRIBUTION OF
DISPOSITION SLIP DISPOSITION SLlT|MM —■
—Registrar prepares Disposition slip for each patient discharged from hospital for any reason.
___________________ —Forwards prior to 2400 hours of day
ABSENCE REQUEST, ABSENCE REQUEST | °n Wh'ch dlscharge occurs- ABSENCE REQUEST |
WD AGO FORM 8170 WD AGO 8170 MMM ■■■A WD AGO 8-170
—Prepares and forwards for each patient desiring to —Receives,
go on pass, furlough, or leave. —Takes necessary action.
—Forwards prior to 2400 hours on day on which absence begins.
INTERWARD TRANSFER SLIP, td I
WD AGO FORM 8-169 | C A G O 8 ^9 |—
—Nurse in charge of receiving ward completes and forwards through the Information Office for each transfer between wards or between hospital and convalescent facilities.
—Medical Officer ordering a transfer to quarters prepares and forwards slip through the Information Office.
WARD MORNING REPORT, WAR°blGRNING I
WD AGO FORM 8-107 WD AGO 8-107
—Nurse in charge of ward at 2400 hours completes Ward Morning Report and forwards.
ADMISSION AND DISPOSITION SHEET STENCIL
NOTE I. It will be noted that the records in the column entitled "Ward" are prepared and forwarded by the Ward Officer or personnel working under his direction. The Ward Officer will be held responsible for the prompt forwarding of such records.
ADMISSION AND DISPOSITION SHEET
ADMISSION AND I DISPOSITION SHEET |
-Files for permanent reference. D^mQN 5^^
—Files for permanent reference.
2.20
TM 8-262
CHAPTER II
I FEB 1945
ADMISSION AND DISPOSITION SHEET
ADMITTING OFFICE
OTHER RECEIVING AGENCIES
LOCATOR CARD FILE
—Uses as check on other records for preparation of Admission and Disposition Sheet stencil.
DISPOSITION SLIP
—Uses as basis for data on Admission and Disposition Sheet stencil.
—Destroys.
ABSENCE REQUEST WD AGO 8-170
—Receives on day of departure on absence.
—Uses as basis for data on Admission and Disposition Sheet stencil.
—Holds in suspense until patient's return.
—Checks files daily to ascertain cases of absence without official leave. {Regular Pass List is checked for other absences.)
INTERWARD TRANSFER SLIP WD AGO 8-169
—Uses as basis for data on Admission and Disposition Sheet stencil.
—Destroys.
WARD MORNING REPORT WD AGO 8-107
—Uses as check for all items for Admission and Disposition Sheet stencil.
—Uses to prepare Consolidated Ward Morning Report.
—Destroys.
Destroy after reproduction
ADMISSION AND DISPOSITION SHEET STENCIL
—Consolidates all data pertaining to admissions, dispositions, interward transfers, and other changes in status in previous 24 hour period.
—Cuts stencil after 0001.
18 A & D SHEET
117 A & D SHEET
« 116 A & D SHEET
« 115 A & D $HEET
’ I14 A & D SHEET
\ |l3 A & D SHEET TJk
’ l'? ‘ £ '' —i
\ III A & D SHEET |Z--
\ 110 A & D SHEET
\ 19 A & D SHEET
« 18 a & p sheet
« 17_ A & D SHEET ImmL
« f6 a & p sheet iZX
, [ 5 A & D SHEET
\ 14 A & D SHEET
, 13 A & D SHEET
I, 12 A & D SHEET | n ADMISSION & |
X DIS^'T'ON I File
~ onttl ■
—Runs off stencil on duplicating machine prior to 0700.
—Prepares copies. Number will vary with required distribution.
—Distributes no later than 0700.
—Files one copy in permanent file.
18 A & D SHEET | |l7 A & D SHEET |
« |l6 A & D SHEET I
' |I5 A & D SHEET |
14 A & D SHEET | |l3 A & D SHEET |
, ||2 A & D SHEET I
\ |l I A & D SHEET |
110 A & D SHEET | v 19 A & D SHEET |
« 18 A & D SHEET |
« 17 A & D SHEET | a |6 A & D SHEET |
• I5 A & D SHEET I
4 ADMISSION & DISPOSITION
SHEET
—Each receiving agency checks locator card files and other records to bring them up to date. Receiving agencies will include:
I. The Commanding Officer.
2. Adjutant.
3. Executive Officer.
4. Chiefs of Professional Services.
5. Sergeant Major.
6. Information Office.
7. Mess Office.
8. Medical Supply Office.
9. Baggage Room.
10. Post Office.
I I. Red Cross.
12. Chaplain.
I 3. Commanding Officer of each Organization showing an admission or disposition. (For station hospitals.)
14. Port Postal Authorities.
15. Other Interested Agencies.
—Each receiving agency files its copy for varying lengths of time, depending on the need; ultimately destroys copy.
2.21
TM 8-262
CHAPTER II
I FEB 1945
ADMISSION AND DISPOSITION SHEET
BLANK GENERAL HOSPITAL FORT CORWIN, VIRGINIA
ADMISSION AND DISPOSITION SHEET
15 November 1944
ADMISSIONS
Trfd
REGISTER NUMBER J14633 (14631

ASTERISK IS PLACED BESIDE NAMES 1*14621
OF PATIENTS RETURNED FROM OVERSEAS FOR CONVENIENCE (*14623
OF PORT POSTAL AUTHORITIES 14630
14628
Fort Miller SH Connelly, Robert C 33 613 739 Sgt COB 80 Sig Ser 1 Dann, Wallace D 34 96I 677 Cpl Hq 4802 SCSU Infl J 0830 LD 15 0830 LD 14
GROUP ADMISSIONS FROM SAME SOURCE
14625
Todd, George R Rodgers, Francis Halloran
0 737 895 J. 32 302 885 Capt S/3gt
Jacobs, Albert C 31 785 620 DIRECT Fr Cmd Sgt
Ashton, Ray E 17 147 003 Cpl
Harvey, Paul L 31 409 452 Cas Pvt
Proper Station: Camp Cramer, Texas ((
GH
Inf Inf Unasgd 0945 1030 ( LD ( LD 17 14
Hq Co XVth Corps Eng 1415 ld! 1 22
Btry A, 650th FA Bn 1700 NIDI 1-21
Co C 81st CML Bn Eng arrison Prisoner) 1600 LD 23
HOUR OF ADMISSION OR DISCHARGE
LINE OF DUFY STATUS FOR MORNING REPORT PURPOSES
14622 Jones, James R
Others
Civ Empl Quartermaster (Off)
CHANGE OF STATUS IN
Parnell, Paul L 0 1 705 386
Johnson, Harold W 1 34 036 641
Lofton, Guy C 33 938 847
Koontz, Wilfred L 38 229 376
Cooper, James E 34 847 563
Fr Sk Lv 1st Lt DC
Unasgd
2300
15
Hq
Bn 85th Inf Regt
3rd
2330
23
6OOth FA Bn
1400
22
DISPOSITIONS
QM TRK Co I 211113
0915
0915
M J
2115
2200
20
22
21
22
39
31
744
246
A 586th CAC(AA)
C 1287th Engr Bn
157
386
ID NLD
Bruce, Kerwin Howard, Henry
Co Co
Sgt Cpl
4037th
Co B 79th Cml Bn I 111114
Fr Conv Fur . Cpl ' Pfc
Fr Abs Sk
Cpl Btry A
Fr AWOL Pvt
WARD NUMBER
PHYSICAL PRO-
FILE SERIAL
ON ALL DISCHARGES TO
DUTY
INSTRUCTIONS FOR PREPARATION
Use same order of entries each day. Arrange similar changes in groups wherever possible. Do not repeat as single entries those which can be grouped under one heading. Arrange similar items in columns. Use of name and location of organizations permits ready distribution of sheet to all interested agencies, and locates all morning report data in one place.
2.22
TM 8-262
CHAPTER II
I FEB 1945
ADMISSION AND DISPOSITION SHEET (CONT'D)
Trfd to Crile GH
As of 13 Nov
842
Reddy, Joseph R
34
I
N
D
A &
- 2 -
18
22
1240th
1260th
Haney, Morris R Cheeseman, James
12 Nov Koslaff, Clarence
15 Nov Creshaw, Edward J
35 to 10
21 to 18
Bibbin, Joseph C G-ddy, Otis
15 084 509 should read 15 804 459
Pfc should read Pvt
Sk, Schick GH
Cpl Inf Unasgd
As of
11 it
CORRECTIONS
Sheet as of 12 Nov - Willis, Paul E '* " " 14 Nov - Hodges, James
Abs
699
INTERWARD TRANSFERS to 26 to 15
INCLUDES CORRECTIONS IN NAMES, SERIAL NUMBERS. ETC.
FOR MORNING REPORT PURPOSES.
CHANGE IN STATUS. AS FOR CDD.
1 FOR MORNING REPORT PURPOSES.
Goodwin, Thomas C *Giles, Stephen R 37 737 092 33 930 287 Tec 5 Pfc Co A 85th Inf Regt Inf Unasgd 111323 211321 1015 1015 LD LD 27 27
^Shaffer, Daniel W Fulton, William L 19 33 013 342 217 332 CDD s/slt Sgt Others Inf Unasgd-22 Brown St Brooklyn, N Y CAC Unasgd-1427 Main St Hamilton, Ky LD LD 32 30
Wilson, Thomas C Civ Dep CHANGE T/Sgt John C Wilson, OF STATUS OUT Sk Lv MD, Blank ( 1H 26
Taylor, James I 0 372 241 Capt An Lv Inf Unasgd 15 days 0930 15
Roberts, George W 0 293 406 Maj Fur Unasgd 7 days 0900 15
Francis, Wesley C 19 169 731 s?sgt AC Unasgd 21 days 1000 22
Neal, Frank A 34 952 384 Cpl AWOL MP Det 1230th SCSU 15 days 1100 27
Irwin, James F 33 123 201 Pfc Hq 1227th SCSU 0800 16
miscellaneous
SCSU Ft Dix, N J, to MP Unasgd
SCSU Ft Dix, N J, to DEML Unasgd
Captain, MAC Registrar
2.23
TM 8-262
CHAPTER II
I FEB 1945
SOURCES OF DATA FOR THE
ADMISSION AND DISPOSITION SHEET
Blake GH
Pvt
11
067 928
34 278
P
No
27
27th Inf
Div
W
2
27
Va.
Belvoir,
D
Capt HAP
27
1020
LD Unk
Mrs Robert Doe (M) 78 Wellman St Brookline, Mass
7/12 1 Sep 44
Tr, SH Fort
Doe, John C Pvt
Doe, John C
LOCATOR CARD Source of data for all admissions
DISPOSITION SLIP Source of data for all dispositions
BLANK GENERAL HOSPITAL FORT CORWIN, VIRGINIA
DISPOSITION SLIP
TO: Chief of ___________ Service
WARD //_________________DATE Jo
&-
(Surname) kz (Christian Name)
Zxc-
(Rank) (Co.) (Organisation)
Patient recommended for:
Transfer Furlough
Discharge Leave
Remark _____________________
TO: C.O., Detachment of Patients
PftTE,
Office Chief Service
Approved Dlsappi oved (Ae^xJ^ Service
DATE 2_\ iDpj 4-q-
T0: Admitting Office: Disposition:^!^^
■---------____________________________
Hour of Departure: 10 QO______________
Proper Station: q-An/_______________
______________________________________
rmp-rMFof1 Patients
2.24
----------------------------------------------------------------------------------------------------------
""" NAME* (£«•*, Firat, Mid. Init.),*$*. GRADE WARD DATE
IT'T’.o. ABSENCE REQUEST s
FORM NO. 8-170 1 July 1944 I °
| Tp: (Checfc one) TYPE OF ABSENCE REQUESTED (Check one)
S ADJUTANT (for Officer Pet tenta) OFFICER PATIENTS ALL. ENLISTED PERSONNEL
C.O., DET. M.O. (for Enliated duty Personnel) SICK LEAVE ANNUAL LEAVE SPECIAL PASS FURLOUGH C.O., DET. PTS. (for Enlieted Patient a) y
LENGTH OF TIME REQUESTED ~~~ TO VISIT (Street. R.F.D., City. State)
FROM (DATE & HOUR) TO (DATE & HOUR)
—-----------------------------------------——— /•&O o
QgQO A>X^J- | JVOO >u^ ___________________
00 YOU HAVE SUFFICIENT FUNDS TO MAKE THE JOURNEY? REASON FOR REQUEST
(Check) SYES __________________________>H>_____________________ , SIGNATURE OF APPLICANT 'SIGNATURE OR STAMp OF WARD 0FFICER_______________APPROVED: ‘SIGNATURE OR STAMP OF APPROVING AUTHORITY
/^^nc.
If disapproved, reason for action ano signature will be entered IN THIS SPACE
INSTRUCTIONS: Prepare one copy and forward to proper office aa far in advance of effective date aa poaaible. If approved, paas, furlough, or apecial order will be returned to ward. Form will then be forwarded to A&D office for their information.
•'TYPED NAME AND GRADE NOT REQUIRED ______________________________
24-033S3-2M
TM 8-262
CHAPTER II
U. S. GOVERNMENT PRINTING OFFICE 0—1945
2.25
TM I
I FEB 1945 CHAP
SOURCES OF DATA FOR THE ADMISSION AND DISPOSITION SHEET (CONT'D)
r7ENT77Tv7",—^ecim date of passes regular pass list 2 y as""
1 JULY 19UU____________________________________________ * _____________________ I
LAST NAME, FIRST NAME, N.I. GRADE ASN FROM (HOUR ON LYJ TO (DATE I HOUR) DESTINATION
; Zf7 U 4m mJ Mo__________q^oq /f 4Z I I
dv,qAxPaQ sx_clU-M- —Li-os— o^oo ZW .'Yyli 6_________________________________________ I
JxOiiFufi, - 2d Ip^ _____0 __l&Ka Ndv ' ------ I
KX*- aU'fflp ma 0 'd4t~~ idixf fay <> 6goo 18b Tte.n |
^approval s^ou, Q ~TL
______/[> /|_| 4 U-fl WARD OFFICER , _________COMMANDING OFFICER DETACHMENT OF PATIENTS I
Forward to Commanding Offjfer Detachment of Patients prior to time designated by Commanding Officer. Use separate liata for passes effective on different days. Approved passes will be returned to the ward on effective day.
,... .. .. . —
""‘”".0., form ro. INTERWARD TRANSFER SLIP
I JULY 1944 \
LASt NAME FIRST NAME MIDDLE INITIAL ARMY S EK I AL NUMBER GRADE
jk 3g )a-4¥f2. M ..
,A.O.g.FormNo.S-107.a»t«f)8 July 19«, »H»h sw »»l l» X? I
uecd upon receipt of thia revision. _9
1001895404