NVDH hospital summary sheet for Jack Coffelt, admission 7/19/73
Document date 19 July 1973
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Id: Cooper-Part-86:039-039
Subject: Cooper Files: Cooper-Part-86:039-039 Document: NVDH hospital summary sheet for Jack Coffelt, admission 7/19/73 Id: Cooper-Part-86:039-039 Page: https://cooper.theunsolved.net/documents/Cooper-Part-86%3A039-039 What is wrong (title, date, type, which pages belong together, copies)? What does the scan show?
A person reads every report. Corrections are made by hand, to the data — titles, dates, names, which pages belong together — never to the scans, and they can take a while to appear.
FBI 164-81, Vault Part 86 p. 39 (DB Cooper-37883), Form, dated 19 Jul 1973 — cooper.theunsolved.net/documents/Cooper-Part-86%3A039-039
SUMMARY SHEET A:NO S:YES
NORTHERN VIRGINIA DOCTORS HOSPITAL
NAME: COFFELT, JACK - TELEPHONE: 521-4665 PREVIOUS ADMISS. TO NVDH: YES [X] NO [ ] TIME OF ADMISSION: 2:15pm ADMISSION DATE: 7/19/73
ADDRESS: 4208 S. 12th RD. ARL. VA. 22204 AGE: 48 SEX: M [X] F [ ] RACE: W [X] C [ ] MARITAL STATUS: S [X] M [ ] W [ ] DIV. [ ] SEP. [ ]
DATE OF BIRTH: 2/20/25 BIRTH PLACE: MISSOURI RELIGION: PROT. OCCUPATION: PHYSICIST ACCOMODATION: PRIV. [ ] SEMI PRIV. [X] CARDIAC [ ] ROOM NO.: 348 ROOM RATE: 66.00
ADMITTING DIAGNOSIS: THROMBOPHLEBITIS
NOTIFY IN EMERGENCY: [blank] RELATIONSHIP: [blank] OFF. PHONE: [blank] HOME PHONE: [blank] DEPOSIT: [blank] ADM. BY: [blank]
INSURANCE: GHI CONTRACT NO: 159-1727 CODE NO: 1110-B EFF: 6/1/72
INSURED THROUGH: SELF EMPLOYER: IBM CORP. (UNABLE TO GIVE PHONE#) BUS. PHONE: b6 b7C
CAUSE FOR ADMISSION: Thrombophlebit[is] [handwritten, partially illegible]
PHYSICAL FINDINGS: [handwritten, partially illegible] got [illegible] order left leg [illegible]
LABORATORY FINDINGS: [handwritten] By CBC K UA
OPERATIVE PROCEDURES AND DATES: [blank] CODE: [blank]
OPERATIVE FINDINGS: [blank]
SUMMARY OF HOSPITAL COURSE: [handwritten, partially illegible] [guess: Treated with] [guess: bedrest] [illegible] x [illegible] [handwritten] [guess: cleared] as [guess: pt off] [guess: Hep] 7/[guess: 31]/73
FINAL DIAGNOSIS: Thrombophlebit - left [guess: saphen] - [guess: thigh] CODE: 451.0
COMPLICATIONS: 0 CONSULTATION WITH: 0 DISCHARGE DATE: 7-31-73
CONDITION ON DISCHARGE: RECOVERED [ ] IMPROVED [X] SAVED [ ] NOT TREATED [ ] D X. ONLY [ ] AUTOPSY [ ] COPY TO PHYSICIAN -- YES [X] NO [ ]
M.D.: b6 b7C
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DB Cooper-37883
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79883
Serials: 79883