(1) Enter "Dir" for direct admission from other than Emergency Room (ER).
(2) Enter "Dir-ER" for direct admission from the ER.
(3) Enter "Trnsf" when the patient has been transferred from any other facility.
(4) Enter `CRO" for carded for record only cases.
(5) Enter "NB" for live-born infant born at your MFT.
z. Ward. Enter the ward/nursing unit to which the patient is admitted. Leave blank
for CRO.
(1) Enter "Abs SK" for AD patients whose entire period of hospitalization is in a
non U.S. Armed Services MTF and have never transferred to a military MTF.
aa. Name/ relationship, address, and telephone number of emergency
addressee. Enter information relating to the emergency addressee. Leave blank for
CRO.
bb. Name and location of MTF. Enter the name and location of the reporting
MTF.
MD0752
1-22