Template:Medical Record: Difference between revisions

From 118Wiki
Jump to navigation Jump to search
No edit summary
No edit summary
Line 9: Line 9:
|width{{=}}700}}
|width{{=}}700}}


<onlyinclude>
<onlyinclude>{{Medical Record LCARS
{|style="max-width:700px"
|SERIAL NUMBER= VS - 108 - 427
|style="background:teal;" width="100"|
|BIRTHYEAR= 2356
|width="600" colspan=2|[[File:Starfleet Medical.png|right|150px|link=Category:Medical Records]]
|BIRTHMONTH= 12
===LAST NAME, FIRST NAME MIDDLE NAME===
|BIRTHDATE= 15
*'''[[StarFleet Serial Number Register|Patient Reference Number:]]''' EZ - 123 - 456
|SEX= Female
*'''Date of Birth:'''
|SPECIES= [[Kriosian]]
**'''Age:''' {{age|2360|03|31}}
|HEIGHT= 161 cm (5'3")
*'''Sex:'''
|WEIGHT= 56 kilos (123 lbs)
*'''Species:'''
|BLOOD TYPE= K3
|-
|T/E RATING= E4
|style="background:teal; border-radius: 0 0 0 14px; border:0px solid #AFA3BF"|
|CHRONIC ILLNESSES= Neurodegenerative disease of unknown origin
|style="background:teal" |
|MEDICATIONS= None
!width=180 align=right style="line-height: 130%;"|<font size="4" color=teal>MEDICAL RECORD</font>
|ALLERGIES & REACTIONS= None
|-
|SEXUAL/REPRODUCTIVE HISTORY= None
|style="background:teal; border-radius: 14px 0 0 0; border:0px solid #AFA3BF"|
|PAST HOSPITALIZATIONS/SERIOUS ILLNESS=
|colspan=2|
*'''2383:''' Physical Rehabilitation, [[Medical Starbase 253]]
*'''Height:''' 178 cm (5'10")
|PAST SURGICAL HISTORY=
*'''Weight:''' 73 kilos (160 lbs)
*'''2390:''' Nanite neurograft
*'''Blood Type:'''
**'''Surgeons:''' Ven Demar, MD; {{n|Niccolò|del Vedova}}, MD
*'''[[T/E Rating]]:'''
**'''OR Site:''' {{USS|Mercury}}
|-
*'''SD 239101.12:''' 4th and 5th Digit Prosthetic Replacement on Left Hand
|style="background:teal;"|
**'''Surgeon:''' {{n|Niccolò|del Vedova}}, MD
|colspan=2|
**'''OR Site:''' {{USS|Garuda}}
===PAST MEDICAL HISTORY===
**[http://sims.starbase118.net/posts/223306 Op Note]
*'''Chronic Illnesses:'''
|PSYCHIATRIC HISTORY= None
*'''Medications:'''
|ALCOHOL USE= None
*'''Allergies and Reactions:'''
|RECREATIONAL DRUG USE= None
*'''Sexual/Reproductive History:'''
|OTHER SUBSTANCE USE= None
|-
|MOTHER MEDICAL HISTORY= None
|style="background:teal;"|
|FATHER MEDICAL HISTORY= None
|colspan=2|
|SIBLING MEDICAL HISTORY= None
===PAST HOSPITALIZATIONS/SERIOUS ILLNESS===
|MARITAL STATUS & SPOUSE= Single
*'''SD 237005.05:'''
|CHILDREN= None
*'''SD 237007.05:'''
|OCCUPATION= Engineer
|DIET= Kriosian nutritional supplement
|EXERCISE= Running, 3 times a week
|PHYSICIANS NOTE=
*'''SD 239007.12 - 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.
<hr>
*'''SD 239110.07 - 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.
|COUNSELORS NOTE=
*'''SD 239110.04 - Counselor:''' {{n|Raissa|Moonsong}}, MD
*'''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.
}}


===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]]
[[Category:Medical Records]]
</onlyinclude>
</onlyinclude>

Revision as of 06:39, 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: K3
  • T/E Rating: E4

PAST MEDICAL HISTORY

  • Chronic Illnesses: Neurodegenerative disease of unknown origin
  • Medications: None
  • Allergies and Reactions: None
  • Sexual/Reproductive History: None

PAST HOSPITALIZATIONS/SERIOUS ILLNESS

PAST SURGICAL HISTORY

PSYCHIATRIC HISTORY

None

SUBSTANCE USE HISTORY

  • Alcohol: None
  • Recreation Drugs: None
  • Other: None

FAMILY MEDICAL HISTORY

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

SOCIAL HISTORY

  • Marital status: Single
  • Children: None
  • Occupation/Assignment: Engineer
  • Diet: Kriosian nutritional supplement
  • Exercise: Running, 3 times a week

PHYSICIANS' NOTES

  • SD 239007.12 - Medical Officer: 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.

  • SD 239110.07 - Medical Officer: Niccolò del Vedova, MD
  • Addendum: Per request of Lieutenant 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.

COUNSELORS' NOTES

  • SD 239110.04 - Counselor: Raissa Moonsong, MD
  • Counseling Assessment: Per request of Lieutenant 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.