Quantcast Military Health (Medical) Treatment Record  Jacket  (NAVMED  6150/10-19)

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record unless approved by NAVMEDCOM. These may include other SF, DD, and NAVMED forms, as well as forms of other Federal medical facilities documenting health care. Pertinent health care information from local or civilian practitioner forms may be transcribed onto SF 600 for incorporation in the treatment record. Cumulative forms shall be filed in their assigned sequence, with the most recent form placed on top of each previous form. All dates recorded on the component forms of the health record will be entered in the follow- ing sequence: day (numeral), month (abbreviated to the first three letter all in capitals), and year (two or four numerals); e.g., 4 JAN 86 or 4 JAN 1986. Military Health (Medical) Treatment Record Jacket (NAVMED 6150/10-19) A new military health (medical) treatment record jacket is prepared when a health record is opened or when the existing jacket has been damaged or is deteriorating to a point of illegibil- ity. The old jacket will be destroyed following replacement. A felt-tip or indelible black-ink pen is used to record all identifying data except the information recorded on the inside of the front leaf. The information in the inside of the front leaf shall be recorded in pencil to permit changes and updating. See figure 10-2, a sample form NAVMED 6150/16, in the preparation of the treatment record jacket. Each treatment record jacket has the second to the last digit of the SSN preprinted on it. The preprinted digit also matches the last digit of the form number (e.g., the preprinted digit on NAVMED 6150/16 is 6). The color of the treat- ment record jacket corresponds to the preprinted digit as follows: Preprinted Digit Jacket Color 0 1 2 3 4 5 6 7 8 9 Orange Light Green Yellow Gray Tan Light Blue White Brown Pink Red In preparing a member’s treatment record jacket, select a prenumbered NAVMED 6150/ 10-19 jacket by matching the second to the last number of the member’s SSN. Enter the rest of the member’s SSN. For members who do not have a SSN (e.g., foreign military personnel), use NAVMED 6150/19 as the treatment record jacket. A “substitute” SSN shall be created for these members by assigning the numbers “9999” as the last four digits of the SSN and assigning the first 5 digits in number sequence (e. g., first SSN 000-01-9999, the second SSN 000-02-9999). Place a piece of black cellophane tape over the number that corresponds to the last digit of the SSN in each of the two number scales. Enter the member’s family member prefix code in the two diamonds preceding the SSN. For all Navy and Marine Corps members, the prefix code of 20 shall be entered. A family member prefix code of 00 shall be used for all foreign military personnel. The member’s full name (last, first, middle, in that order) is entered in the upper right corner. Indicate no middle name by the abbreviation “NMN.” If the member uses initials instead of first or mid- dle names, show this by enclosing the initials in quotation marks (e.g., “J” “C”). Also, indicate titles, such as JR, SR, and III, at the end of the name. The name may be written on the line pro- vided or be imprinted on a self-adhesive label and attached to the jacket in the patient’s identifica- tion box, Special categories of records, i.e., per- sonnel in flight status or the Asbestos Medical Surveillance Program, shall be identified by stamping or printing the appropriate entry in the lowest portion of the patient’s identification block. Additionally, flag and general officers shall be identified in a like manner.” Immediately below the name, indicate in the alert box whether the member has sensitivities or allergies by entering an “X” in the appropriate box. If there are no allergies or sensitivities, leave it blank. To the left of the alert box, indicate the record category by entering an “X” in the box marked “Outpatient (Military Health).” Below the record category box, indicate the member’s branch of military service by entering an “X” in the appropriate box. If the individual is not an Army, Navy, Air Force, or Marine Corps member, enter an “X” in the “Other Categories” box and write the individual service on the line provided. The record retirement tape box is to be left blank. Immediately below the retirement year tape box is a similar box that shall be used to in- dicate the record category. All military (medical) treatment records shall be identified with red tape. 10-10


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