Ae AEE oe a ARKHAM SANATORIUM ———= 225 E. DERBY ST., ARKHAM, MASSACHUSETTS ADMISSION FORM Patient's Name_Cecil Hunter naa Home Adress: 82 French Hill Scree Professton/Oooupation:fine Acts student 8 Race: White sex:_M “age. 2S neignt:S'&" Weight: 97las Hair, Ort Wd Byes: brown _ Next of Kin Charles Leiter = elephone Number: Pending Home Adrees,__ 725 College Street. Se NATURE OF ABERRATION OR MENTAL DISORDER Wolloal History of eurrent condition Patient apparently under anxiety crisis and cumulative stress. Symptoms present as shortness of breath, rapid heartocat and mental confusion. Professional Giagnosis Social Phobia, Bipolar Affective Disorder and Major Depression History of Uisonders, payShological crises and pievious Weataente There-is no report of previous insanity episodes. Pacient makes continuous use of antidepressant medication. Possibly under chemical dependencies, a5 shown by blood and tokicological analysis. ADMISSION CONDITION Psychiatric doo Br Liam Cofi Finl | Voluntary Admission? Signature: Lula xamtssion date U9//7/ 20 Cite lhe Blood Pressyre Pulse ‘Temperature ‘Respiratory Rate 140790 ‘ 17 996 37 opm Tnitial patient Gagncola Nervous Collapse ana Psychotic Outbreak * & Peroonal belongings cubtrattel by the tean during the tine of heepltaization Clothes, wristwatch, notebook and a set of keys TREATMENT PPLAN x Medication Therapy Increased dosage of calming Rest, meditation and weekly and anxiolytic Anugs conversation sessions with therapists’