| Title: | [Sample Chronological Record of Medical Care Form] |
| Date: | Undated |
| Origin: | United States. Army |
| Document type: | Chronological Record of Medical Care |
| [Classification Unknown] | Annotated Copy |
| Pages: | 2 p. |
| Location of original: | American Civil Liberties Union |
| Releasing agency: | United States. Army |
| ACLU notes: | Blank forms listing symptoms of physical and mental status. |
| 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: | 2010-09-07 |
