Paris under Napoleon offers the earliest example of medical patient triage in a metropolis. A central admitting office opened at the Hotel-Dieu of Paris in 1801 under the supervision of a municipal hospital council. It admitted about 22,000 patients in the first eighteen months. This number represented about 44% of all applicants; another 16,000 were admitted to various hospitals as emergencies; the rest were treated as outpatients and helped on the spot or referred to district welfare offices, dispensaries, and nursing homes. Thus the historian can discern a concerted effort by hospital authorities to keep indigent patients out of the hospital.