|Date of Injury:|
|D.O.B/Age when admitted:|
|Cause of Incident:|
Enemy Action. Hurricane caught fire, bailed out.
|Transferred to QVH:|
Burns to face, hands and legs. Shrapnel wounds.
|No. of Operations at East Grinstead:|
This is to certify that the patient mentioned below and whose description is stated hereon is the authorised holder of this Identity card.
|Age at Death:|
|Dr Rank:||Dr Unit:|