HOSPITAL

ADMISSION
Listen and fill in the admission form for the
patient
answer
• Surname:HUSSEIN
• First name MUSTAFA
• Gender: MALE
• DOB 1-SEPTEMEBR/9-1982
• Place of birth KARACHII PAKISTAN
• Occupation PAINTER
• Marital status SINGLE
• Next of kin;HIS BROTHER -YUSUF
• Contact no 07709401229
• Smoking intake YES, 20 A DAY
• Alcohol intake NO
• Reason for admission: concussion
• Medical history -
• Family history MY MOTHER’S PARENT: GRANDPARENTS