Template:Medical Record

You can use this template to create a medical record for your character: 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 Insert {{subst:Medical Record}} into the body of the new subpage and click save. Click edit once the page is created and fill out the details as you wish. Example: Rahman, Roshanara/Medical Record The patient reference number is from the StarFleet Serial Number Register and is also used as the student ID in the academic transcript template from Starfleet Academy.

	Medical Record Patient Reference Number: EZ - 123 - 456 Date of Birth: 236301.01 Age: 38 Sex: Female Species: Human
		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 SD 238911.12: Knee surgery Surgeon: Niccolò del Vedova, MD OR Site: USS Mercury Op Note: Link to sim
	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.