1. INSTITUTION: Bedlam Hospital
2. LAST NAME/FIRST NAME/MIDDLE INITIAL: (No Surname) Ni Luh Anak Agung Istri Sumati (Goes by Sumati)
3. SEX: Female
4. RELIGION: Balinese Hinduism
5. MARITAL STATUS: Single
6. AGE AT ADMISSION: 25
7. LEGAL STATUS AT ADMISSION: Involuntary
8. LOCATION FROM WHICH ADMITTED: Bali, Indonesia
9. EDUCATION: Elementary school, some secondary school
10. USUAL OCCUPATION: Hotel concierge
11. ESTABLISHED DIAGNOSIS, MENTAL DISORDER: Dissociative Trance Disorder
12. ESTABLISHED DIAGNOSIS, OTHER CONDITIONS: If in a trance =, or triggered, is not violent but may cause harm to herself as a form of violence
13. WARD: 1