Lyanna Avery/Medical Record: Difference between revisions

Revision as of 05:37, 16 May 2014

	LAST NAME, FIRST NAME MIDDLE NAME Patient Reference Number: TA - 221 - 808 Date of Birth: 236607.11 Age: 35 Sex: Female Species: Terran
		MEDICAL RECORD
	Height: 170.7 cm (5'6") Weight: 63.5 kilos (140 lbs) Blood Type: T/E Rating:
	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 4: / Line 4: @@
 |width="600" colspan=2|[[File:Starfleet Medical.png|right|150px|link=Category:Medical Records]]
 ===LAST NAME, FIRST NAME MIDDLE NAME===
-*'''[[StarFleet Serial Number Register|Patient Reference Number:]]''' EZ - 123 - 456
+*'''[[StarFleet Serial Number Register|Patient Reference Number:]]''' TA - 221 - 808
-*'''Date of Birth:'''
+*'''Date of Birth: 236607.11
-**'''Age:''' {{age|2360|03|31}}
+**'''Age:''' {{age|2366|07|11}}
-*'''Sex:'''
+*'''Sex: Female
-*'''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:''' 170.7 cm (5'6")
-*'''Weight:''' 73 kilos (160 lbs)
+*'''Weight:''' 63.5 kilos (140 lbs)
 *'''Blood Type:'''
 *'''[[T/E Rating]]:'''