Every entry on DA Form 3647-1 exists because a record system needs it in writing. The form's official title is INPATIENT TREATMENT RECORD COVER SHEET (FOR PLATE IMPRINTING), and it is raised whenever an office must inpatient treatment record cover sheet (for plate imprinting) in a way that survives the departure of everyone involved. Memory does not transfer between assignments; a filed document does. The edition dated 05/01/1979, status ACTIVE, is what stands here, spread across 2 page(s) and about 161 fields — a count that reflects how much detail the receiving system requires, not how much the drafter wishes to give.
Two offices stand behind the form, and the distinction between them explains most of what follows. TSG is the proponent: it decides what the form asks and revises it when the underlying process changes. AR 40-400 is the prescribing authority: it decides when the form is raised at all and where the completed document travels. Content and occasion are separated deliberately, so that a change in procedure does not require redesigning the page.
Retrieval governs the order of entry. The head of the form takes name, identification number, unit and date, and those values become the handles by which the record is found later — the substantive blocks are never searched on. This is why the spelling must match official records exactly rather than approximately.
The rules of entry all trace back to the page being fixed in advance. Tabbing follows the order built into the form, which usually matches how the page reads and misses less than clicking. An exclusive group discards the earlier selection because contradictory entries would make the record unusable. One-line fields have no wrap because print positions are predetermined, so an overlong entry displays fully and prints truncated. Longer text goes to the remarks area or a continuation, both provided for exactly that. Where nothing applies, the nil mark is entered — a blank leaves the reader unable to tell a considered answer from a skipped one.
A signature is what converts entries into a record, which is why it comes last and why an unsigned form remains a draft however complete it looks. Where a reviewing official, an approving authority or a witness also signs, each adds a distinct attestation, and each dates the day of signing rather than the day of preparation — the dates trace the sequence of responsibility. The recurring defects are worth knowing precisely because they defeat that purpose: an empty mandatory field leaves an obligation unmet, transposed identification digits attach the record to nobody, a date with day and month reversed puts events in the wrong order, and entries left in a reused working copy assert facts nobody intended.
Behind the Privacy Act statement is a requirement that anyone asked for personal data be told, in advance, under what authority it is sought, for what purpose, who else routinely sees it, and whether refusal is possible. Reading it after completing the fields defeats its function. And the completed form is itself a personal record from that point on, subject to the handling rules such records carry.
Download the form
Why several files for one page? Because the form has to be completed in a headquarters and in places without a workstation, and PDF, XFDL covers both. The fillable pdf holds interactive fields that fix each entry in place and remove handwriting from the equation. The printable pdf is the same layout without those fields, meant for a printer and a pen. Neither is a lesser copy of the other; each answers a condition the other cannot.
Where a file opens matters more than it appears to. A browser will display a pdf, but browser viewers were built to read documents, and some accept keystrokes into fields they never intended to store — the entries are gone at tab close, without warning, because saving was never part of what that viewer does. A dedicated reader is built around the file's own structure and keeps what you enter. The xfdl file belongs to a different lineage entirely: IBM Lotus Forms, adopted across Army systems for the routing and signature handling built into it. That is why only the Lotus Forms Viewer reads it.
Downloads are free and unregistered. The material was published for general use, and the files are passed on unaltered.
What the form asks for
- AdmitOff
- CAUSE
- CONT_B
- Cont_A
- ContentArea1
- ContentArea2
- Continue
- DIAGNOSES
- Data
- DataItems
- Date
- Days_A
- Days_AA
- Days_AB
- Days_AC
- Days_AD
- Days_AE
- Days_AF
- Days_B
- Days_C
- Days_D
- Days_E
- Days_F
- Page1
Disposition is prescribed, not chosen. AR 40-400 names the destination, whether that is a specific office, the unit administrative channel or the personal record, and the applicable records schedule governs how long it survives there. Both rules exist to keep the file consistent across offices with different habits. Take your copy before the document leaves, since it will not come back.
Related documents are located by series and number, and the relation is rarely accidental — forms under one proponent or one directive tend to serve steps of a single procedure. Anything the DA series form names on its face normally travels with it, as do the continuations, covers and transmittals the process generates. Assembling them together is what makes the submission a complete account.
An edition marks the form at a point in a process that keeps moving, and the date printed on the page is what distinguishes one from another. Since a saved file never announces its own obsolescence, compare its date against the current edition before using it again. Prior executions remain valid: the change applies forward, and a record is read against the edition it was written under.
One boundary should be stated clearly. What is distributed here are copies of published Department of the Army forms; the site is independent, issues nothing of its own, and holds no position in the system it describes. Proponency, prescribing directives and retention schedules operate without reference to it. Consequently nothing here is legal advice and no assurance about acceptance is possible. Questions about a particular entry, a requirement or eligibility belong with TSG or your servicing administrative office.
Questions and answers
- What is DA Form 3647-1?
- INPATIENT TREATMENT RECORD COVER SHEET (FOR PLATE IMPRINTING)
- Which edition is current?
- 05/01/1979
- Who is responsible for this form?
- TSG
- In which formats can it be downloaded?
- PDF, XFDL, PDF