a) The patient's code number (16 digits on UNIMED's card);
b) The name and telephone of the person who is requesting the removal;
c) Name, age and sex of the patient;
d) Pathology (if known) / symptoms;
e) City where the patient is;
f) Name and telephone of the hospital where the patient is;
g) Name and telephone of the patient's doctor;
h) City where the patient will go;
i) Name and telephone of the patient's destination hospital;
j) Name and telephone of the doctor who will assist the patient at the destination (if kno).
