Ben Livingston/Medical Record: Difference between revisions

Revision as of 01:59, 11 May 2014

	LIVINGSTON, BENJAMIN HAROLD Patient Reference Number: BW - 250 - 197 Date of Birth: 236004.21 Age: 41 Sex: Male Species: Terran
		MEDICAL RECORD
	Height: 1.7 m (5'7") Weight: 64 kg (141 lbs) Blood Type: A Negative T/E Rating: None
	PAST MEDICAL HISTORY Chronic Illnesses: Medications: Allergies and Reactions: Sexual/Reproductive History:
	PAST HOSPITALIZATIONS/SERIOUS ILLNESS SD 237005.05: SD 237007.05: PAST SURGICAL HISTORY SD 237005.05: SD 237007.05:
	PSYCHIATRIC HISTORY SUBSTANCE USE HISTORY Alcohol: Recreation Drugs: Other:
	FAMILY MEDICAL HISTORY Mother: Father: Siblings:
	SOCIAL HISTORY Marital status: Children: Occupation/Assignment: Diet: Exercise:

	PHYSICIANS' NOTES Medical Officer: Medical Assessment:
	COUNSELORS' NOTES Counselor: Psychological Assessment:

@@ Line 3: / Line 3: @@
 |style="background:teal;" width="100"|
 |width="600" colspan=2|[[File:Starfleet Medical.png|right|150px|link=Category:Medical Records]]
-===LAST NAME, FIRST NAME MIDDLE NAME===
+===LIVINGSTON, BENJAMIN HAROLD===
-*'''[[StarFleet Serial Number Register|Patient Reference Number:]]''' EZ - 123 - 456
+*'''[[StarFleet Serial Number Register|Patient Reference Number:]]''' BW - 250 - 197
-*'''Date of Birth:'''
+*'''Date of Birth:''' 236004.21
 **'''Age:''' {{age|2360|03|31}}
-*'''Sex:'''
+*'''Sex:''' Male
-*'''Species:'''
+*'''Species:''' Terran
 |-
 |style="background:teal; border-radius: 0 0 0 14px; border:0px solid #AFA3BF"|
@@ Line 16: / Line 16: @@
 |style="background:teal; border-radius: 14px 0 0 0; border:0px solid #AFA3BF"|
 |colspan=2|
-*'''Height:''' 178 cm (5'10")
+*'''Height:''' 1.7 m (5'7")
-*'''Weight:''' 73 kilos (160 lbs)
+*'''Weight:''' 64 kg (141 lbs)
-*'''Blood Type:'''
+*'''Blood Type:''' A Negative
-*'''[[T/E Rating]]:'''
+*'''[[T/E Rating]]:''' None
 |-
 |style="background:teal;"|
 |colspan=2|
 ===PAST MEDICAL HISTORY===
 *'''Chronic Illnesses:'''