Post by Cockey Von Murdertits on Dec 22, 2011 22:38:47 GMT -5
PATIENT'S FORM
Date of admission:
Name:
Age and Sex:
Patient's Appearance: A link or a written description works fine
Married, Single or Widowed:
Has any family?:
Occupation:
Religious persuasion:
Brought by whom?:
Form of Insanity:
Supposed cause:
Is hereditary?:
Is Suicidal?:
Is dangerous to others?:
Is destructive to property?:
State of bodily health?:
Marks of violence, if any:
Facts specified in medical certificate, upon which opinion of insanity founded:
DOCTOR'S FORM
Name:
Age and Sex:
Employee's Appearance: Again, a link to a picture or a written description is fine
Has any family?:
Married, Single, or Widowed:
Occupation: (What kind of doctor are you? Psychologist, surgeon, etc.)
Religious Persuasion:
Form of Insanity, if any:
Any diseases, hereditary or otherwise:
If you have been assigned to an inmate, specify who he/she is please:
Ward A for those suffering from "manageable" illnesses; aka those that are entirely lucid and suffer from depression and the like.
Ward B are for those who are mostly lucid but occasionally are more dangerous than other patients.
Ward C are for those with unmanageable illnesses, people who have committed criminal acts and have been deemed insane and a danger to society.
The Isolation Ward is an under-ward of Ward C that is used to punish patients from Wards A and B, but also as a more secure ward for truly dangerous patients.
Note: No one ever stays permanently in the Isolation Ward, however - or at least, that's not the plan. .
Date of admission:
Name:
Age and Sex:
Patient's Appearance: A link or a written description works fine
Married, Single or Widowed:
Has any family?:
Occupation:
Religious persuasion:
Brought by whom?:
Form of Insanity:
Supposed cause:
Is hereditary?:
Is Suicidal?:
Is dangerous to others?:
Is destructive to property?:
State of bodily health?:
Marks of violence, if any:
Facts specified in medical certificate, upon which opinion of insanity founded:
DOCTOR'S FORM
Name:
Age and Sex:
Employee's Appearance: Again, a link to a picture or a written description is fine
Has any family?:
Married, Single, or Widowed:
Occupation: (What kind of doctor are you? Psychologist, surgeon, etc.)
Religious Persuasion:
Form of Insanity, if any:
Any diseases, hereditary or otherwise:
If you have been assigned to an inmate, specify who he/she is please:
Ward A for those suffering from "manageable" illnesses; aka those that are entirely lucid and suffer from depression and the like.
Ward B are for those who are mostly lucid but occasionally are more dangerous than other patients.
Ward C are for those with unmanageable illnesses, people who have committed criminal acts and have been deemed insane and a danger to society.
The Isolation Ward is an under-ward of Ward C that is used to punish patients from Wards A and B, but also as a more secure ward for truly dangerous patients.
Note: No one ever stays permanently in the Isolation Ward, however - or at least, that's not the plan. .
