SOLUTIONS TO EXERCISES, LESSON 3
1. Circumstances; causative agent; whether injury was deliberately self-inflicted or
inflicted by another person; place and date injury occurred, whether injury occurred
2.
a.
Original to: In patient Treatment Record.
b.
Copy 1 to: Health Record/Outpatient Treatment Record.
c.
Copy 2 to: Register Number Index.
d.
Copy 3 (Worksheet Copy) placed after the original in the Inpatient
3. Principal procedure first, regardless of date, then in chronological sequence
4. To serve as a medical and administrative summary of each case; an essential
document for Health Record/Outpatient Treatment Record; a source document for
medical statistical information, and a legal document for third party liability cases.
6. Signature in appropriate block on ITRCS physician's worksheet copy. (para 3 -4c)
10. Chief, Patient Administration Division and the health care provider. (para 3 -1d)
11. a. DA Form 3647 for typed entries.
b. DA Form 3647 for computer-generated continuous form printing.
14. Admission and Coding Information (DA Form 2985). (para 3-5a)
15. a. All admissions as bed patients.
b. Liveborn infants.
MD0753
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