Apr. 2nd, 2014

madfortea: (don't mess with tea)
No. ### 2234391

Patient Admittance Form ### Asylum du Mal Idees



GIVEN NAME ###



Mad Hatter



AGE AND SEX ###



male, uncertain (appears in his 30s)



SPECIES ###



human



ORIGIN ###



Underland (Tim Burton's AiW movie)



FAMILY ###



none



OCCUPATION ###



hatter



FORM OF INSANITY ###



general psychosis



SUPPOSED CAUSE ###



mercury poisoning



INDICATIVE FACTORS ###



obvious due to profession



DANGEROUS TO OTHERS ###



no



DANGEROUS TO SELF ###



no



DESTRUCTIVE TO PROPERTY ###



occasional small items



STATE OF BODILY HEALTH ###



good



IDENTIFYING FEATURES (IF ANY) ###



none














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Mad Hatter

April 2014

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