6. A physician who makes a report under this Chapter must provide the following information:(1) name of the intoxication, infection or disease being reported;
(2) name, sex, occupation, date of birth, address with postal code, telephone number and health insurance number of the person affected;
(3) date of the onset of the disease;
(4) where samples have been taken for laboratory analysis, the date on which the samples were taken and the name of the laboratories that will analyse them;
(5) his or her name and professional permit number, and telephone number where he or she can be reached;
(6) in the case of a report of viral hepatitis, babesiosis, brucellosis, Q fever, viral haemorrhagic fever, Creutzfeldt-Jakob disease and its variants, Chagas disease, Lyme disease, Plasmodium infection, rabies, syphillis, tuberculosis, West Nile virus infection, arthropod-borne viral encephalitis or of a report made pursuant to section 4, all information pertaining to blood, organ or tissue donations made by the person affected and all information pertaining to blood, blood products, organs and tissues received by the person affected;
(7) in the case of a report of syphilis, if it is primary, secondary, latent of less than or more than one year, congenital, tertiary, or any other form.