1. Age?

2. Time (to nearest hour)?

3. Address for recall at end of test: ’42 West Street’

4. Year?

5. Name of hospital?

6. Recognition of two persons (e.g., doctor, nurse)?

7. Date of birth (day and month)?

8. Year of First World War?

9. Name of reigning monarch?

10. Ask to recall the address given earlier (’42 West Street’)