{
  "patientFirstName": "",
  "patientLastName": "",
  "patientBirthday": "",
  "patientSex": "",
  "passportImage": "",
  "passportNumber": "",
  "passportIssuingCountry": "",
  "passportExpiryDate": "",
  "vaccinationRecordCard": "",
  "vaccinationRecordFirstDose": false,
  "vaccinationRecordFirstDoseBrand": "",
  "vaccinationRecordFirstDoseDate": "",
  "vaccinationRecordSecondDose": false,
  "vaccinationRecordSecondDoseBrand": "",
  "vaccinationRecordSecondDoseDate": "",
  "vaccinationRecordThirdDose": false,
  "vaccinationRecordThirdDoseBrand": "",
  "vaccinationRecordThirdDoseDate": "",
  "vaccinationRecordFourthDose": false,
  "vaccinationRecordFourthDoseBrand": "",
  "vaccinationRecordFourthDoseDate": "",
  "travelDestination": "",
  "travelDepartureDate": ""
}