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nahn-SEK-wuh-tuhr



Posts : 83
Join date : 2011-12-20

PostSubject: Itakshir   Tue Dec 20, 2011 8:00 pm

1. INSTITUTION: Bedlam Hospital
2. LAST NAME/FIRST NAME/MIDDLE INITIAL: Itakshir; Medvedev/Izot/K.; Yamasaki/Saburou
3. SEX: M.
4. RELIGION: Unknown
5. MARITAL STATUS: Single
6. AGE AT ADMISSION: Unknown (est. mid-twenties)
7. LEGAL STATUS AT ADMISSION: Voluntary
8. LOCATION FROM WHICH ADMITTED: Iturup Island, Russia
9. EDUCATION: None
10. USUAL OCCUPATION: Fisherman
11. ESTABLISHED DIAGNOSIS, MENTAL DISORDER: Dissociative Amnesia
12. ESTABLISHED DIAGNOSIS, OTHER CONDITIONS: none
13. WARD: 1
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