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  • Individual Sick Slip - dd689

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    bustos
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    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. The unit commander and medical officer sections note their findings on the condition and disposition of the patient including whether they will be placed on sick bay, hospital, or other duty status. Both the commander and medical officer must sign the form.

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    Sick Call

    Original Title

    Individual Sick Slip_dd689

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    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. The unit commander and medical officer sections note their findings on the condition and disposition of the patient including whether they will be placed on sick bay, hospital, or other duty status. Both the commander and medical officer must sign the form.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    39 views1 page

    Individual Sick Slip - dd689

    Uploaded by

    bustos
    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. The unit commander and medical officer sections note their findings on the condition and disposition of the patient including whether they will be placed on sick bay, hospital, or other duty status. Both the commander and medical officer must sign the form.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    INDIVIDUAL SICK SLIP DATE

    ILLNESS INJURY

    LAST NAME - FIRST NAME - MIDDLE INITIAL OF PATIENT ORGANIZATION AND STATION

    SERVICE NUMBER/SSN GRADE/RATE

    UNIT COMMANDER'S SECTION MEDICAL OFFICER'S SECTION


    IN LINE OF DUTY IN LINE OF DUTY

    REMARKS DISPOSITION OF PATIENT DUTY QUARTERS

    SICK BAY HOSPITAL

    NOT EXAMINED OTHER (Specify):

    REMARKS

    SIGNATURE OF UNIT COMMANDER SIGNATURE OF MEDICAL OFFICER

    DD FORM 689, MAR 63 PREVIOUS EDITIONS ARE OBSOLETE.


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