1. INSTITUTION: Bedlam Hospital
2. LAST NAME/FIRST NAME/MIDDLE INITIAL: Van Aemstel, Diederik
3. SEX: M.
4. RELIGION: Unspecified
5. MARITAL STATUS: Single
6. AGE AT ADMISSION: 40
7. LEGAL STATUS AT ADMISSION: Involuntary
8. LOCATION FROM WHICH ADMITTED: Amsterdam, the Netherlands
9. EDUCATION: Unknown
10. USUAL OCCUPATION: Retired, former captain (shipping industry)
11. ESTABLISHED DIAGNOSIS, MENTAL DISORDER: Emotionally Unstable Personality Disorder (Impulsive Type)
12. ESTABLISHED DIAGNOSIS, OTHER CONDITIONS: Selective Mutism, suspected Cannabis Dependence, liable to experience Severe Nicotine Withdrawal
13. WARD: 3