| Description | Gives admission number, date of the present admission, the patient's name, sex and class, age, marital status, previous occupation, previous place of abode, name, address and relationship of next-of-kin, by whose authority sent, date of medical certificate and by whom signed, physical condition, name of disease, class of defective, whether epileptic, age at onset of mental deficiency, and observations (usually date of discharge or death). |