Template:Medical Record: Difference between revisions

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<onlyinclude>{{Medical Record LCARS
<onlyinclude>{{Medical Record LCARS
|SERIAL NUMBER= VS - 108 - 427
|SERIAL NUMBER= EZ - 123 - 456
|BIRTHYEAR= 2356
|BIRTHYEAR= 2363
|BIRTHMONTH= 12
|BIRTHMONTH= 01
|BIRTHDATE= 15
|BIRTHDATE= 01
|SEX= Female
|SEX= Female
|SPECIES= [[Kriosian]]
|SPECIES= [[Human]]
|HEIGHT= 161 cm (5'3")
|HEIGHT= 161 cm (5'3")
|WEIGHT= 56 kilos (123 lbs)
|WEIGHT= 56 kilos (123 lbs)
|BLOOD TYPE= K3
|BLOOD TYPE= B+
|T/E RATING= E4
|T/E RATING= T0
|CHRONIC ILLNESSES= Neurodegenerative disease of unknown origin
|CHRONIC ILLNESSES= None
|MEDICATIONS= None
|MEDICATIONS= None
|ALLERGIES & REACTIONS= None
|ALLERGIES & REACTIONS= Strawberries (hives)
|SEXUAL/REPRODUCTIVE HISTORY= None
|SEXUAL/REPRODUCTIVE HISTORY= Longterm male partner
|PAST HOSPITALIZATIONS/SERIOUS ILLNESS=
|PAST HOSPITALIZATIONS/SERIOUS ILLNESS=
*'''2383:''' Physical Rehabilitation, [[Medical Starbase 253]]
*'''2388:''' Tarkalean flu
|PAST SURGICAL HISTORY=
|PAST SURGICAL HISTORY=
*'''2390:''' Nanite neurograft
*'''SD 238911.12:''' Knee surgery
**'''Surgeons:''' Ven Demar, MD; {{n|Niccolò|del Vedova}}, MD
**'''Surgeon:''' {{n|Niccolò|del Vedova}}, MD
**'''OR Site:''' {{USS|Mercury}}
**'''OR Site:''' {{USS|Mercury}}
*'''SD 239101.12:''' 4th and 5th Digit Prosthetic Replacement on Left Hand
**'''Op Note:''' Link to sim
**'''Surgeon:''' {{n|Niccolò|del Vedova}}, MD
**'''OR Site:''' {{USS|Garuda}}
**[http://sims.starbase118.net/posts/223306 Op Note]
|PSYCHIATRIC HISTORY= None
|PSYCHIATRIC HISTORY= None
|ALCOHOL USE= None
|ALCOHOL USE= 2 glasses of wine per week
|RECREATIONAL DRUG USE= None
|RECREATIONAL DRUG USE= None
|OTHER SUBSTANCE USE= None
|OTHER SUBSTANCE USE= None
|MOTHER MEDICAL HISTORY= None
|MOTHER MEDICAL HISTORY= None
|FATHER MEDICAL HISTORY= None
|FATHER MEDICAL HISTORY= Cardiovascular disease
|SIBLING MEDICAL HISTORY= None
|SIBLING MEDICAL HISTORY= None
|MARITAL STATUS & SPOUSE= Single
|MARITAL STATUS & SPOUSE= Married to Elliot Smith
|CHILDREN= None
|CHILDREN= 1 son
|OCCUPATION= Engineer
|OCCUPATION= Helmsman
|DIET= Kriosian nutritional supplement
|DIET= Vegetarian
|EXERCISE= Running, 3 times a week
|EXERCISE= Running, 3 times a week
|PHYSICIANS NOTE=
|PHYSICIANS NOTE=
*'''SD 239007.12 - Medical Officer:''' {{n|Niccolò|del Vedova}}, MD
*'''SD 239004.23 - Medical Officer:''' {{n|Niccolò|del Vedova}}, MD
*'''Medical Assessment:''' Lt. Commander Rahman is a 33-year-old Kriosian female who presents with persistent headaches and loss of concentration. She states the symptoms began late last year and have progressively gotten worse. I have tried various conventional medications and therapy, which have not helped. She underwent a nanite neurograft to strengthen her neuronal tissue, but it appears this has had the unfortunate effect that her neuroplasticity has only been reinforced. The current plan is to continue monitoring her condition as I seek alternative therapies.
*'''Medical Assessment:''' Ensign Smith is a 27-year-old human female who presents with abdominal pain and generalized weakness. She states the symptoms began last Thursday after eating a bowl of Commander McLaughin's "Sweet Chili Surprise" at the ship's annual cook off contest. I've started her on an intense bowel cleansing therapy which should be followed to completion through the next week.
<hr>
<hr>
*'''SD 239110.07 - Medical Officer:''' {{n|Niccolò|del Vedova}}, MD
*'''SD 239004.27 - Medical Officer:''' {{n|Niccolò|del Vedova}}, MD
*'''Addendum:''' Per request of Lieutenant {{n|Sean|Naughton}}, SB118 JAG, I have reviewed Rahman's condition and concur with the conclusion that given her susceptibility to suggestion, she is unfit for duty at this time.
*'''Addendum:''' Ensign Smith returned to sickbay today stating she felt much better, insisting that her cleansing therapy was no longer necessary. I told her nonsense and sent her on her way.
|COUNSELORS NOTE=
|COUNSELORS NOTE=
*'''SD 239110.04 - Counselor:''' {{n|Raissa|Moonsong}}, MD
*'''SD 239004.28 - Counselor:''' Lt. Rachel Simmons
*'''Counseling Assessment:''' Per request of Lieutenant {{n|Sean|Naughton}}, SB118 JAG, I met with Rahman to assess her competence to stand trial. However, due to the JAG officer's interruption of my session with the lieutenant commander, I was unable to complete my assessment. I recommend that she be given a complete evaluation at StarBase 118 before her case moves forward.
*'''Counseling Assessment:''' Ensign Smith came to my office today in tears. It seems her recent medical illness due to her unfortunate encounter with McLaughlin's chili has left her feeling vulnerable and alone. I have advised her to continue daily therapy sessions with me until further notice.
}}
}}



Revision as of 07:03, 12 October 2014

You can use this template to create a medical record for your character:
  1. Create a new subpage for your character by adding "/Medical Record" to the end of your character's current bio page.
    The new page will have the address Last Name, First Name/Medical Record
  2. Insert {{subst:Medical Record}} into the body of the new subpage and click save.
  3. Click edit once the page is created and fill out the details as you wish.

Example: Rahman, Roshanara/Medical Record


Starfleet Medical.png

Medical Record

MEDICAL RECORD
  • Height: 161 cm (5'3")
  • Weight: 56 kilos (123 lbs)
  • Blood Type: B+
  • T/E Rating: T0

PAST MEDICAL HISTORY

  • Chronic Illnesses: None
  • Medications: None
  • Allergies and Reactions: Strawberries (hives)
  • Sexual/Reproductive History: Longterm male partner

PAST HOSPITALIZATIONS/SERIOUS ILLNESS

  • 2388: Tarkalean flu

PAST SURGICAL HISTORY

PSYCHIATRIC HISTORY

None

SUBSTANCE USE HISTORY

  • Alcohol: 2 glasses of wine per week
  • Recreation Drugs: None
  • Other: None

FAMILY MEDICAL HISTORY

  • Parent 1 (Mother): None
  • Parent 2 (Father): Cardiovascular disease
  • Siblings: None

SOCIAL HISTORY

  • Marital status: Married to Elliot Smith
  • Children: 1 son
  • Occupation/Assignment: Helmsman
  • Diet: Vegetarian
  • Exercise: Running, 3 times a week

PHYSICIANS' NOTES

  • SD 239004.23 - Medical Officer: Niccolò del Vedova, MD
  • Medical Assessment: Ensign Smith is a 27-year-old human female who presents with abdominal pain and generalized weakness. She states the symptoms began last Thursday after eating a bowl of Commander McLaughin's "Sweet Chili Surprise" at the ship's annual cook off contest. I've started her on an intense bowel cleansing therapy which should be followed to completion through the next week.

  • SD 239004.27 - Medical Officer: Niccolò del Vedova, MD
  • Addendum: Ensign Smith returned to sickbay today stating she felt much better, insisting that her cleansing therapy was no longer necessary. I told her nonsense and sent her on her way.

COUNSELORS' NOTES

  • SD 239004.28 - Counselor: Lt. Rachel Simmons
  • Counseling Assessment: Ensign Smith came to my office today in tears. It seems her recent medical illness due to her unfortunate encounter with McLaughlin's chili has left her feeling vulnerable and alone. I have advised her to continue daily therapy sessions with me until further notice.