From at least 1845 and the proclamation of An Act for the Regulation of the Care and Treatment of Lunatics (8 & 9 Vic c.100), public asylums and licensed houses were required to maintain a Register of Patients. Initially the register maintained by licensed houses was officially known as the Book of Admissions. In some institutions the Register was also known as an Admissions Register or as an Admission and Discharge Register and these terms were sometimes stamped on the volumes.
Immediately upon the admission of a person to an asylum, the clerk of the asylum was required to make an entry in the Register of Patients. Details recorded included: patient's name; date of admission; admission number; date of last previous admission; age; marital status; occupation; previous place of abode; religion and the form of mental disorder and state of physical health. Further details were entered in the register on the death, transfer or discharge of a patient. Institutions were also required to maintain a separate Register of Discharges, Removals and Deaths, usually known as a Discharge Register.
The format of the Register of Patients which was specified in a schedule to the Lunacy Statute and succeeding legislation, changed little until the proclamation of the Mental Health Act 1959 in 1962. The record then became officially known as the Register of Patients and Discharge Register and included information about the types of admission. The following five types of admission were specified under sections 41 to 49 of the Mental Health Act 1959:
Voluntary Boarders (V) were those who entered the hospital at their own request or, if under the age of 16 at the request of a parent or guardian and on the opinion of a medical practitioner.
Recommended (R) and Approved (A) Patients. A person could be admitted upon the recommendation set out in a prescribed form, of a medical practitioner who had examined the person. As soon as possible after admission the superintendent of the hospital was required to examine the patient and either approve the recommended admission or discharge the patient.
Judicial Admissions (J). Upon information provided on oath before a justice that a mentally ill person was not receiving proper care, or could not support himself/herself or had committed an offence and after examination by two medical practitioners, an order could be made for the person to be admitted to or detained in a mental hospital.
Security Patients (S) were those who had been detained in a gaol but were transferred to a mental hospital upon being determined to be mentally ill.
The Register of Patients and Discharge Register officially superseded the separate Discharge Register, however some institutions continued to maintain a separate record of patient discharges, transfers and deaths.