Heilbrigðisskýrslur - 04.12.1987, Qupperneq 130

TRANSLATION OF JOURNAL (FYLGISKJÖL I)
Name
Address
Date of birth
Occupation
Identity number
Teleph. number
Time of arrival
Date of arrival in emergency deptartment
Surgeon receiving patient, name.
TRANSPORT TO HOSPITAL:
1 Ambulance
2 With police escort
3 Other
TIME SINCE ACCIDENT OCCURRED OR SIGNS OF SICKNESS:
1 Less than one hour
2 1-4 hours
3 4-24 hours
4 More than 24 hours
CAUSES:
01 - Traffic accident
02 - Poison
03 - Fall or stumbling
04 - Burn - heat - cold
05 - Shooting arms
06 - Fall into water
07 - Electricity
08 - Self mutilation
09 - Mutilation by others
10 - Inebriation
11 - Sports
12 - Machines
13 - Other tools
14 - Hits by objects
15 - Damage caused by medical treatment
16 - Bites
17 - Horse
18 - Other causes
19 - Unknown
PLACE OF ACCIDENT
01 - Workshop - factory
02 - Accident at sea
03 - Accident at building work
04 - Other work accidents
05 - Accident at school
06 - Home accidents
07 - Accidents out of doors not at work
08 - Accident at or in vicinity of place of amusement
09 - At other places/unknown/no place of accident
128