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Use to report bed availability and medical treatment element (MTE) status when MEDSITREP record message is not or can not be used. Reference: FM 8-10-5.

LINE 1 — DATE AND TIME______________________________(DTG)

LINE 2 — UNIT________________________________________(Unit Making Report)

LINE 3 — ELEMENT____________________________________(Name or Designator of the Reporting Element)

LINE 4 — TOTAL OPERATIONAL ________________________(Total Number of Beds That Are Operational)

LINE 5 — MEDICAL OPERATIONAL______________________(Number of Medical (MM) Beds Operational)

LINE 6 — PSYCHIATRIC OPERATIONAL__________________(Number of Psychiatric (MP) Beds Operational)

LINE 7 — GENERAL OPERATIONAL______________________(Number of General Surgeries (SS) Beds Operational)

LINE 8 — ORTHOPEDIC OPERATIONAL___________________(Number of Orthopedic (SO) Beds Operational)

LINE 9 — BURN OPERATIONAL _________________________(Number of Burn (SB) Beds Operational)

LINE 10 — SPINAL CORD OPERATIONAL_________________(Number of Spinal Cord (SC) Injury Beds Operational)

LINE 11 — OB/GYN OPERATIONAL______________________(Number of OB/GYN (SG) Beds Operational)

LINE 12 — PEDIATRIC OPERATIONAL____________________(Number of Pediatric (MC) Beds Operational)

LINE 13 — NEURO OPERATIONAL_______________________(Number of Neurosurgery (SSN) Beds Operational)

LINE 14 — ORAL OPERATIONAL_________________________(Number of Oral/Maxillofacial (SSM) Operational)

LINE 15 — OPHTHALMOLOGY OPERATIONAL____________(Number of Ophthalmology (SSO) Beds Operational)

LINE 16 — THORACIC OPERATIONAL____________________(Number of Thoracic Surgery (SSC) Beds Operational)

**Use lines 13 through 16 to report the number of operational beds in selected surgical sub-specialties. Include these numbers in line 6.

LINE 17 — AVAILABLE TOTAL__________________________(Total Number of Available Beds)

LINE 18 — AVAILABLE MEDICAL________________________(Number of Medical (MM) Beds Available)

LINE 19 — AVAILABLE PSYCHIATRIC____________________(Number of Psychiatric (MP) Beds Available)

LINE 20 — AVAILABLE GENERAL________________________(Number of General Surgery (SS) Beds Available)

LINE 21 — AVAILABLE ORTHOPEDIC ____________________(Number of Orthopedic (SO) Beds Available)

LINE 22 — AVAILABLE BURN___________________________(Number of Burn (SB) Beds Available)

LINE 23 — AVAILABLE SPINAL CORD____________________(Number of Spinal Cord (SC) Injury Beds Available)

LINE 24 — AVAILABLE OB/GYN_________________________(Number of OB/GYN (SG) Beds Available)

LINE 25 — AVAILABLE PEDIATRIC ______________________(Number of Pediatric (MC) Beds Available)

**Use lines 17 through 25 to report the number of available beds for patients at the reporting medical element.

LINE 26 — AVAILABLE NEURO__________________________(Number of Neurosurgery (SSN) Available)

LINE 27 — AVAILABLE ORAL___________________________(Number of Oral/Maxillofacial (SSM) Beds Available)

LINE 28 — AVAILABLE OPHTHALMOLOGY_______________(Number of Ophthalmology (SSO) Beds Available)

LINE 29 — AVAILABLE THORACIC_______________________(Number of Thoracic Surgery (SSC) Beds Available)

**Use lines 26 through 29 to report the number of available beds in selected surgical sub-specialties. Include these numbers in line 19.

LINE 30 — SUITES_____________________________________(Number of Operating Suites That Are Operational)

LINE 31 — BACKLOG__________________________________(Number of Hours Surgical Backlog)

LINE 32 — OVERFLOW_________________________________(Number of Overflow/ Holding Beds Available)

LINE 33 — NARRATIVE_________________________________(Free Text for Additional Information Required for Clarification of Report

**Use lines 30 through 33 to provide additional information concerning medical element status, workload, and other amplifying data.

**Repeat lines 3 through 33 for multiple missions or sets of mission data. Assign sequential line numbers to succeeding iterations; for example, first iteration 11 through 15; second iteration 11a through 15a; third iteration 11b through 15b; and so on.

LINE 34 — AUTHENTICATION___________________________(Report Authentication)

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