In the nineteenth century, admission papers were posted to the Steward of Bethlem Royal Hospital in advance of the weekly meeting of the Bethlem Sub-Committee. Most of those for whom admission papers were completed were admitted to the Hospital, usually seven days after the Sub-Committee had approved their admission. However, a minority were not admitted, either because the petition relating to their admission was refused by the Sub-Committee, or, in cases in which the petition was approved, because (for whatever reason) they were not brought to the hospital to be admitted. Admission papers were not numbered and filed until admission, and papers relating to those who were not admitted must have been discarded in the normal course of events. Papers of those who were not admitted in 1815-1816 and 1848 seem to have been preserved by accident amongst the papers of those who were admitted. Unlike the main run of patient admission papers, the papers dating from 1848 often include letters from petitioners, doctors and others - perhaps because letters relating to admitted patients were removed for inclusion in the relevant casebook entry, or in other files.