TEXT: This HPLHS Prop Document is for entertainment purposes only.
  Designed and implemented by Andrew Leman. © 2002 by HPLHS. All rights
  reserved. Permission is hereby granted for the user to print copies for
  his/her personal use in role-playing games. No other permission is granted,
  and any commercial or illegal use of this digital file or the prop you can
  make with it is ENTIRELY PROHIBITED.
  Please do not distribute this document.
  It is available from www.cthulhulives.org
  Questions? Ask them.
  andrew@ahleman.com
  ASYLUM PATIENT RECORD
  This prop is based on actual vintage hospital paperwork.
  Enter information at top of form using built-in Acrobat
  form fields (or delete default entries and print prop
  “blank”, and enter info using a real typewriter or by
  hand).
  Print the following page on any kind of paper you want. 
  Enter treatments, remarks, notes, and signatures by
  hand. Use a rubber stamp for the dates, if possible.
  
  Sefton Asylum        PATIENT PROGRESS RECORD
  pat i e n t ’ s n a m e :
  dat e o f b i r t h :
  S e x :
  H T:
  W T:
  C O LO R :
  a d m i t t e d :
  D i s c h a r g e d :
  n e x t o f k i n :
  A d d r es s :
  d o c t o r :
  a s s i s ta n t:
  m o n t h    y e a r
  t r e at m e n t
  r e m a r k s
  n o t es :
  s i g n e d :
  Randolph Carter
  Aug. 20, 1890
  M
  5'11"
  165 lbs.
  White
  July 22, 1923
  Helen Carter, aunt
  448 Harvey St. Boston, Mass.
  Vincent Headrick
  Simone Garrett
  
SOURCE: textdata/thevault/Call of Cthulhu (CoC) (BRP) [multi]/EXTRA/IRL Props/Prop FIles/AsylumRecord.pdf