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| Title: | [Sample Transfer Form] |
| Date: | Undated |
| Origin: | United States. Army |
| Document type: | Medical Record |
| [Classification Unknown] | |
| Pages: | 1 p. |
| Location of original: | American Civil Liberties Union |
| Releasing agency: | United States. Army |
| View document: |  |
| Language: | English |
| Collection: | The Torture Archive |
| Rights: | All information displayed in this record, including any PDF image, is public. |
| Repository: | National Security Archive |
| Date available: | 2010-07-20 |