BED DESIGNATIONS [BEDDESIG]

LINE 1 — DATE AND TIME______________________________(DTG)

LINE 2 — UNIT________________________________________(Unit Making Report)

LINE 3 — EVAC FROM__________________________________(Name or Designator of MTE From Which to Move/Evacuate Patients)

LINE 4 — PICKUP______________________________________(UTM or Six-Digit Grid Coordinate With MGRS Grid Zone Designator of PICKUP or Location of MTE From Which Evacuated. Report Only if Other Than Fixed-Wing Aeromedical Evacuation (AE) Will be Used and Transporting Agency May Not Know the PICKUP Location)

LINE 5 — EVAC TO____________________________________(Name or Designator of Destination MTE)

LINE 6 — DELIVERY____________________________________(Delivery Location or Location of Destination MTE, UTM or Six-Digit Grid Coordinate With MGRS Grid Zone Designator)

LINE 7 — NO. MEDICAL (MM)___________________________(Number of MM Beds Assigned to Patients at Destination MTE)

LINE 8 — NO. PSYCHIATRIC (MP)________________________(Number of MP Beds Assigned to Patients at Destination MTE)

LINE 9 — NO. SURGERY (SS)____________________________(Number of SS Beds Assigned to Patients at Destination MTE)

LINE 10 — NO. ORTHOPEDIC (SO)_______________________(Number of SO Beds Assigned to Patients at Destination MTE)

LINE 11 — NO. BURN (SB)______________________________(Number of SB Beds Assigned to Patients at Destination MTE)

LINE 12 — NO. SPINAL CORD (SC)_______________________(Number of SC Beds Assigned to Patients at Destination MTE)

LINE 13 — NO. OB/GYN (SG)____________________________(Number of SG Beds Assigned to Patients at Destination MTE)

LINE 14 — NO. PEDIATRIC (MC)_________________________(Number of MC Beds Assigned to Patients at Destination MTE)

LINE 15 — TOTAL______________________________________(Total Number of Beds Assigned to Patients at Destination MTE)

LINE 16 — NO. NEURO (SSN)____________________________(Number of SSN Beds Assigned to Patients at Destination MTE)

LINE 17 — NO. MAXILLO (SSM)_________________________(Number of SSM Beds Assigned to Patients at Destination MTE)

LINE 18 — NO. OPHTHALMOLOGY (SSO)_________________(Number of SSO Beds Assigned to Patients at Destination MTE)

LINE 19 — NO. THORACIC (SSC)_________________________(Number of SSC Beds Assigned to Patients at Destination MTE)

**Use lines 16 through 19 to report the number of beds assigned to patients in selected surgical subspecialties. Include these numbers in line 8.

LINE 20 — CATEGORY__________________________________(Number of Special Category Patients (Other Than Active Duty US Armed Forces) Assigned Beds at Destination MTE by Medical Specialty Category (EXAMPLE: 2 French Nationals in Category SO. The Number of Patients Reported is Also Included in Lines 6 to 14))

LINE 21 — NARRATIVE_________________________________(Free Text for Additional Information Required for Clarification of Report)

**Repeat lines 3 through 21 for multiple missions or sets of mission data. Assign sequential line numbers to succeeding iterations; for example, first iteration 3 through 21; second iteration 3a through 21a; third iteration 3b through 21b; and so on.

LINE 22 — AUTHENTICATION___________________________(Report Authentication)

**Use lines 20 through 22 to provide additional medical information and other amplifying data.