Army Forms Archive

DA Form 3894 — HOSPITAL REPORT OF DEATH

hospital report of death

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DA Form 3894 is a DA series document issued for use across the Department of the Army. Official title: HOSPITAL REPORT OF DEATH. Purpose: hospital report of death. The current edition carries the date 10/01/1972 and is listed with a publication status of ACTIVE. The form runs to 1 page(s) and contains approximately 200 entry fields.

The office of primary responsibility is TSG. Use is prescribed by AR 40-400, which defines when the form is raised and where it goes afterward. The form is normally completed by the subject of the entries or by administrative personnel maintaining the record, then reviewed and signed as the governing authority directs.

Available formats: PDF, XFDL. Each is a rendering of the same official layout; the content is identical across them and only the means of completion differs. The pdf is the reference copy. Fillable pdf carries interactive form fields; a printable pdf is the same page image without them, intended for pen entry after printing.

The pdf displays in current browsers and in any reader application. For fillable use a full reader is preferable to a browser viewer, since viewers vary in whether entered data is retained. An xfdl file is available too. The format is IBM Lotus Forms, in use across Army form systems, and it opens only in the Lotus Forms Viewer.

Download of every format is free and requires no account. Files are served as published, without alteration to the page image.

What the form asks for

  • ADMINACT
  • ADMINACT_1
  • ADMINACT_2
  • ADMINACT_3
  • ADMINACT_4
  • ADMINACT_5
  • AUTOPSYN
  • AUTOPSYY
  • CAUSE
  • CAUSE2
  • CAUSE3
  • CAUSE4
  • CAUSE4_1
  • CHAPNO
  • CHAPYES
  • CORNERNO
  • CORNERYES
  • ContentArea1
  • DAY
  • DAY_1
  • DAY_2
  • DAY_3
  • DAY_4
  • DAY_5

Completion follows the printed sequence of blocks from the top of the page downward. The heading area takes the identifying particulars — name, identification number, organisation, date of preparation. Retrieval of the record from a file depends on these entries, and they are therefore filled first.

Typed entry is made straight into the interactive fields. The tab key moves through them in the order set at build time, generally matching the reading order of the page. Boxes and buttons respond to a click; in an exclusive group, one selection cancels the others. Single-line fields do not wrap, and anything longer than the field width prints cut off although it may still display in full on screen. Extended text goes to remarks or a continuation sheet rather than into a narrow box.

The signature block is the final entry, made by hand or by an authorised electronic method, and without it the document remains a draft. Countersignatures — review, approval, witness — are added in the sequence printed, dated at the moment of signing and not at preparation. Empty mandatory fields lead the list of defects; an inapplicable field is annotated as such, not passed over. Behind it come digit transposition in identification numbers, day-month inversion in dates, and residual entries surviving from a reused copy in place of a blank form.

A Privacy Act statement appears on the form where personal information is collected. It sets out the authority for collection, the purpose, the routine uses, and whether disclosure is mandatory or voluntary. The statement is read before entry, not after. Completed copies carry personal data and are handled and stored under the safeguards applicable to that data.

Once completed, the form goes where the governing authority directs: to the designated office, along the unit administrative channel, or into the personal file. The preparer retains a copy. The length of retention and the manner of filing are set by the records schedule for the series, not by local arrangement.

Related forms are found by series and number. Documents in the DA series sharing a proponent or a prescribing directive commonly travel together, and a form referenced within the body of another is usually filed with it. Continuation sheets, cover sheets, and transmittal documents belong to this group and are collected before submission rather than after.

Revision by the proponent supersedes an edition. Version is read from the edition date printed on the form itself, and a stored copy is compared against the current edition before it is used again. Documents already executed under an earlier edition are not redone because of the change.

The documents on this page are reproductions of published Department of the Army forms, offered for download. This is an independent site with no connection to the Department of the Army and no authority to issue forms. Nothing stated is legal advice, and no assurance is given regarding acceptance by any office. Doubts about a specific entry, requirement, or eligibility are resolved by the proponent or by the servicing administrative office.

Questions and answers

What is DA Form 3894?
HOSPITAL REPORT OF DEATH
Which edition is current?
10/01/1972
Who is responsible for this form?
TSG
In which formats can it be downloaded?
PDF, XFDL, PDF

Publisher notes

  1. 42-ITEM ONLY PRODUCED IN ELECTRONIC MEDIA,

Other forms in the series