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individual sick slip. 1. medical condition (brief description) illness. injury 2. date (yyyymmdd) 3. patient's name (last, first, middle initial) 4. dod id number 5. grade / rank 6. organization and station unit commander's section 7. in line of duty. 8. remarks 9. signature of unit commander medical officer's section 10. in line of duty
DD Form 689, Individual Sick Slip, March 1963. INDIVIDUAL SICK SLIP DATE. ILLNESS INJURY. LAST NAME - FIRST NAME - MIDDLE INITIAL OF PATIENT. ORGANIZATION AND STATION. ORGANIZATION AND STATION. SERVICE NUMBER/SSN. GRADE/RATE. UNIT COMMANDER'S SECTION.
individual sick slip unit commander's section medical officer's section disposition of patient dd form 689, mar 63 previous editions are obsolete. usappc v2.00 sick bay duty hospital quarters not examined other (specify): illness injury remarks last name-first name-middle initial of patient service number/ssn in line of duty in line of duty date
Title: Individual Sick Slip. Edition Date: 08/01/2017. Authority: AR 40-66; AFI 41-210. For use of this form please contact: The Department of the Army. The official website for the Executive Services Directorate.
Fill out the DD Form 689 Individual Sick Slip online and download it as a print-ready PDF. Get the blank form in Word or PDF format for free.
individual sick slip signature of medical officer unit commander’s section signature of unit commander medical officer’s section disposition of patient dd form 689, mar 63 previous editions are obsolete. usappc v1.00 sick bay duty hospital quarters not examined other (specify): illness injury remarks
individual sick slip illness injury date last name - first name - middle initial of patient service number/ssn grade/rate organization and station ... medical officer's section in line of duty disposition of patient duty quarters sick bay hospital not examined other (specify): remarks signature of medical officer dd form 689, mar 63 previous ...
individual sick slip illness injury date last name - first name - middle initial of patient organization and station ... in line of duty in line of duty remarks disposition of patient sick bay not examined duty hospital quarters other (specify): remarks signature of unit commander signature of medical officer navmed 6310/1 (11-2004) created date:
INDIVIDUAL SICK SLIP UNIT COMMANDER'S SECTION MEDICAL OFFICER'S SECTION DISPOSITION OF PATIENT DD FORM 689, MAR 1963 PREVIOUS EDITIONS ARE OBSOLETE. APD PE v2.00 SICK BAY DUTY HOSPITAL QUARTERS ... army sick call slip, individual sick slip template, sick slip Created Date:
This document is a sick slip form used by the military to document a service member's illness or injury. It collects information about the patient such as name, organization, service number, and grade. It also documents whether the condition occurred in the line of duty.