#!/usr/bin/awk -f

BEGIN {
	OFS="\t"
}

# header
NR==1 {
	f=NF
	$1=$1	#recalc $0 using OFS
	print
	next	#no further processing
}

# new patient
!(($1 OFS $2) in name_to_idx) {
	idx_to_name[++idx]=$1 OFS $2
	name_to_idx[$1 OFS $2]=idx
}

1 {
	for (i=3; i<=f; i++) {
		data[name_to_idx[$1 OFS $2],i]+=$i
	}
}

END {
	for (i=1; i<=idx; i++) {
		printf("%s", idx_to_name[i])
		for (j=3; j<=f; j++)
			printf("%s%s", OFS, data[i,j]?1:0)	#just 1 or 0, not actual sum
		printf("%s",ORS)
	}
}