(1) For civilian employees of Federal agencies, indicate the Federal
department (i.e., Army, Navy, State, Education, Health and Human Services, Justice,
Commerce, Labor, Treasury).
(2) For foreign military personnel, indicate the nation and armed forces with
which the patient is serving such as Federal Republic of Germany, Army.
v. Zip code of residence. For CONUS, Alaska and Hawaii, enter the nine-digit zip
code of the patient's residence. If the last four are unknown, zero-fill these positions. This
field is required for all patients.
w. Military Occupational Specialty (MOS) code. Enter the MOS for the AD
patient. This field is left justified; do not zero-fill. This is a required field for U.S. AD,
Reserve, and National Guard personnel.
x. Previous admission. Enter year of previous admission if patient had been
admitted to your MTF whether for the same or for any other condition. If no previous
admission, check, "No".
y. Source of admission/authority. Include authority for admission paragraphs
from AR 40-3 in this block, see table 1-10.
Data Item and Explanation
Data Code
Direct to military hospital from ER
0
Direct to military hospital from other than ER
1
AD direct to non-U.S. Armed Services hospital never
Transferred to military hospital
3
Initial admission in non-U. S. Armed Services hospital,
Transferred to military (AD only)
4
Initial admission in non-U. S. Armed Services hospital,
(non-AD only)
5
Transfer from U. S. Army hospital
6
Transfer from U. S. Navy hospital
7
Transfer from U. S. Air Force hospital
8
Live birth in this hospital
L
CRO
C
Table 1-10. Source of Admission
MD0752
1-21