Well, I usually only spot one bug at a time when inspecting source code. The next bug (I don't guarantee it is is the last) is that your source document contains elements that are in a namespace, but you are trying to match elements in no namespace. Your stylesheet needs to declare the namespace
xmlns:p="http://www.*************"
and then use this prefix when referring to elements in the source documetn, for example match="p:patient"
Michael Kay
http://www.saxonica.com/
Author, XSLT 2.0 and XPath 2.0 Programmer's Reference