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Department of Defense form 7A. Official designation: DD Form 7A, Report of Treatment Furnished Pay Patients - Outpatient Treatment Furnished (Part B), August 1976. Purpose: Report of Treatment Furnished Pay Patients Outpatient Furnished (Part B). Current edition not stated, status not stated.
Prescribing authority: not stated. Proponent: not stated. Unlike service-specific publications, DD forms carry Department-level authority and apply across the Army, Navy, Air Force, Marine Corps, Space Force and Coast Guard when operating under Defense jurisdiction.
Users include uniformed members of any branch, DoD civilian employees, contractor personnel where authorized, and the administrative staff who process the completed record.
Submission follows the schedule set by not stated and by local implementing procedures. This page provides the blank form for download and general orientation only.
Formats offered: PDF. Length: 1 pages. Fillable field count: roughly 94.
Every listed format is free to download. Modern pdf software handles the pdf files, with the caveat that browser-embedded viewers sometimes ignore field properties that a desktop reader honours.
What the form asks for
- Report control symbol.
- 1. Installation providing treatment (name and address).
- 2. Month and year covered by this report.
- 3. Category of patients.
- 4. Authority for admission.
- 5. Name (Last, first, middle initial) and social security number, line 1.
- 6. Military grade.
- 7. Organization.
- 8. Diagnosis.
- 9. Dates treated.
- 10. Number of days treated.
- 5. Name and social security number, line 2.
- 6. Military grade.
- 7. Organization.
- 8. Diagnosis.
- 9. Dates treated.
- 10. Number of days treated.
- 5. Name and social security number, line 3.
- 6. Military grade.
- 7. Organization.
- 8. Diagnosis.
- 9. Dates treated.
- 10. Number of days treated.
- 5. Name and social security number, line 4.
Completion runs in the order printed on the page: identifying data at the head, the body of the entry next, certification at the foot. Header data frequently governs what belongs in the fields below it.
Edition in use: not stated. Because DD forms are revised at Department level and distributed to all services at once, an obsolete printing may not match the fields an office expects. The date is printed on the form face.
Instructions printed on the form or in not stated govern individual field entries. Where the two differ, the governing publication controls.
After completion, the copy goes to the office designated by not stated or by local procedure. Retention of a personal copy is ordinary practice and costs nothing.
Cross-referenced forms are found through the numbering system. The DD sequence is Department-level and unified, which means a number cited on the page identifies one document across the whole Department.
Where a DA form is cited alongside a DD form, the two belong to different systems: DA numbering is Army-specific and administered by an Army proponent, while DD numbering is Defense-wide under not stated or an equivalent Department office. Numbers do not translate between the systems.
Revision occurs when the prescribing directive is reissued, when the data collected changes, or when statutory notice language is amended. Verification of the edition date at download addresses all three.
Scope of this page: distribution of a published form and description of its contents. It offers no legal guidance and no assurance regarding any particular submission. Direct procedural questions to not stated, to the servicing personnel office, or to the office designated in not stated.
Questions and answers
- What is DD Form 7A?
- DD Form 7A, Report of Treatment Furnished Pay Patients - Outpatient Treatment Furnished (Part B), August 1976
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?