N°

Patient identification

Date symptom onset

Hospitalisation

Pneumonia

Microbiology

Patient status

Risk factors

Places visited

(date if possible)

Comments

residence (first 4 letters)

date of birth

age

sex

occupation

date

location

discharge date

clinical

X-ray

urinary antigen

culture

serology

PCR

current

30-day

work

shop

other

1

2

3

4

5

6

7