Template:LCARS-Navbar: Difference between revisions

Template:LCARS-Navbar (view source)

Revision as of 19:02, 26 June 2014

1,890 bytes added , 26 June 2014

no edit summary

Aigle Phos

2,273

edits

@@ Line 2: / Line 2: @@
 ----
+{|style="max-width:700px"
+|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===
+*'''[[StarFleet Serial Number Register|Patient Reference Number:]]''' EZ - 123 - 456
+*'''Date of Birth:'''
+**'''Age:''' {{age|2360|03|31}}
+*'''Sex:'''
+*'''Species:'''
+|-
+|style="background:teal; border-radius: 0 0 0 14px; border:0px solid #AFA3BF"|
+|style="background:teal" |
+!width=180 align=right|<font size="4" color=teal>MEDICAL RECORD</font>
+|-
+|style="background:teal; border-radius: 14px 0 0 0; border:0px solid #AFA3BF"|
+|colspan=2|
+*'''Height:''' 178 cm (5'10")
+*'''Weight:''' 73 kilos (160 lbs)
+*'''Blood Type:'''
+*'''[[T/E Rating]]:'''
+|-
+|style="background:teal;"|
+|colspan=2|
+===PAST MEDICAL HISTORY===
+*'''Chronic Illnesses:'''
+*'''Medications:'''
+*'''Allergies and Reactions:'''
+*'''Sexual/Reproductive History:'''
+|-
+|style="background:teal;"|
+|colspan=2|
+===PAST HOSPITALIZATIONS/SERIOUS ILLNESS===
+*'''SD 237005.05:'''
+*'''SD 237007.05:'''
+===PAST SURGICAL HISTORY===
+*'''SD 237005.05:'''
+*'''SD 237007.05:'''
+|-
+|style="background:teal;"|
+|colspan=2|
+===PSYCHIATRIC HISTORY===
+===SUBSTANCE USE HISTORY===
+*'''Alcohol:'''
+*'''Recreation Drugs:'''
+*'''Other:'''
+|-
+|style="background:teal;"|
+|colspan=2|
+===FAMILY MEDICAL HISTORY===
+*'''Mother:'''
+*'''Father:'''
+*'''Siblings:'''
+|-
+|style="background:teal;"|
+|colspan=2|
+===SOCIAL HISTORY===
+*'''Marital status:'''
+*'''Children:'''
+*'''Occupation/Assignment:'''
+*'''Diet:'''
+*'''Exercise:'''
+|-
+|style="background:teal;" colspan=3 height=4|
+|-
+|style="background:teal;"|
+|colspan=2|
+===PHYSICIANS' NOTES===
+*'''Medical Officer:'''
+*'''Medical Assessment:'''
+|-
+|style="background:teal;"|
+|colspan=2|
+===COUNSELORS' NOTES===
+*'''Counselor:'''
+*'''Psychological Assessment:'''
+|}
+__NOTOC__
+[[Category:Medical Records]]