NVDH emergency room record (Form 2799), admission February 1973

Document date 8 February 1973

Part 86page 541 pageDB Cooper-37898

Open in FBI Vault (Part 86, page 54 of the PDF)
Report a problem

Email this to [email protected]

Id: Cooper-Part-86:054-054

Subject: Cooper Files: Cooper-Part-86:054-054

Document: NVDH emergency room record (Form 2799), admission February 1973
Id: Cooper-Part-86:054-054
Page: https://cooper.theunsolved.net/documents/Cooper-Part-86%3A054-054

What is wrong (title, date, type, which pages belong together, copies)?


What does the scan show?

Open in email app

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. 54 (DB Cooper-37898), Form, dated 8 Feb 1973 — cooper.theunsolved.net/documents/Cooper-Part-86%3A054-054

NORTHERN VIRGINIA DOCTORS HOSPITAL No. 2799 EMERGENCY ROOM RECORD [guess: Admitted] 324 6 E.S. or H.I.L. No. ☐ Medicare Patient

---

Last Name: [redacted] First Name: [redacted] Middle Name: [redacted] Home Phone: [redacted] Admission Date: 2/8/73 Date of Birth: [redacted] Sex: [redacted] Civil Status: [illegible] Religion: [illegible] Address: [redacted] [guess: Sylvander Lake] Arlington, VA [redacted] Name of Blue Cross and/or Blue Shield: [redacted] Other hospitalization insurance: [illegible] Policy No: [redacted] Group No: [illegible] Contract No: [guess: col] 1110-6 Effective Date: 6/1/72 Subscriber: [redacted] ☐ Compensation Effective Date: [illegible]

---

EMERGENCY ROOM CHARGES Does Not Include Fee of Attending Physician

ITEM | CHARGE | ITEM | CHARGE Emergency Room | | Sutures | Anesthetic | | Tetanus Antitoxin | Central Supply | | Cast | Dressings | | E.O.M. | Drugs | | | Oxygen | | |

OTHER SERVICES RENDERED X-ray _____ b6 Laboratory _____ b7C Physical Therapy _____ EKG _____

---

no known allergies to drugs. BRIEF HISTORY In [illegible] case where, when and how [was] injured, if illness, [describe]: Pt. [guess: having] acute pain in both lower [guess: limbs] [guess: especially] lt. [guess: axis] which [guess: began] this [guess: morning] + has become [guess: progressively] worse.

---

PHYSICIAN'S REPORT CONDITION ON ADMISSION Good ☐ Fair ☐ Poor ☐ Shock ☐ Hemorrhage ☐ Coma ☐ Temp. 98.6 [guess: Oral] Pulse 100 R 24 BP [guess: 150/80] Treatment: Tetanus Toxoid _____ Tetanus Antitoxin _____ Tetanus Antitoxin _____

[guess: Diagnosis]: Thromb[guess: o]phlebitis

Disposition of Case: [guess: To be admitted] Referred to Dr. _____ Date: 7/[guess: 8]/73

INSTRUCTIONS TO PATIENT:

---

DB Cooper-37898

---

b6 b7C

Serials: 2799, 324 6, 37898