Admitted to: --- |
Date of Injury: --- |
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D.O.B/Age when admitted: --- |
Cause of Incident: Crashed at Chivenor. Burned in Wellington. |
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Transferred to QVH: --- |
Injuries: 3rd degree burns to face, hands & buttocks. |
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No. of Operations at East Grinstead: --- |
IDENTITY CARD
This is to certify that the patient mentioned below and whose description is stated hereon is the authorised holder of this Identity card.
Forename: John |
Surname: Smith |
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Service No: --- |
Nationality: --- |
Awards/Honours: --- |
Patient Unit: --- |
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Profession: Flt. Sgt. |
Patient Rank: --- |
Death: --- |
Age at Death: --- |
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Dr Rank: |
Dr Unit: |
Notes:
Glossary: