Fenelli, Mary Mauve/Medical Record: Difference between revisions

From 118Wiki
Jump to navigation Jump to search
(Created page with "{|style="max-width:700px" |style="background:teal;" width="100"| |width="600" colspan=2|right|150px|link=Category:Medical Records ===Fenelli, Ma...")
 
No edit summary
Line 26: Line 26:
*'''Medications:'''
*'''Medications:'''
*'''Allergies and Reactions:'''
*'''Allergies and Reactions:'''
*'''Sexual/Reproductive History:'''
*'''Sexual/Reproductive History:'''  
*'''Trill Symbiosis Status:'''  
|-
|-
|style="background:teal;"|
|style="background:teal;"|
Line 45: Line 44:


===SUBSTANCE USE HISTORY===
===SUBSTANCE USE HISTORY===
*'''Alcohol:''' Infrequent
*'''Alcohol:''' Never
*'''Recreation Drugs:''' Never
*'''Recreation Drugs:''' Never
*'''Other:''' None
*'''Other:''' None

Revision as of 15:36, 26 February 2015

Starfleet Medical.png

Fenelli, Mary Mauve ARNOM

MEDICAL RECORD
  • Height: 1.5 Meters
  • Weight: 65 Kilograms
  • Blood Type: AB
  • T/E Rating: None

PAST MEDICAL HISTORY

  • Chronic Illnesses:
  • Medications:
  • Allergies and Reactions:
  • Sexual/Reproductive History:

PAST HOSPITALIZATIONS/SERIOUS ILLNESS

  • SD :
  • SD :
  • SD :

PAST SURGICAL HISTORY

None

PSYCHIATRIC HISTORY

SUBSTANCE USE HISTORY

  • Alcohol: Never
  • Recreation Drugs: Never
  • Other: None

FAMILY MEDICAL HISTORY

  • Mother:
  • Father:
  • Siblings:

SOCIAL HISTORY

  • Marital status: N/A
  • Children: N/A
  • Occupation/Assignment:
  • Diet:
  • Exercise:

PHYSICIANS' NOTES

  • Medical Officer:
  • Medical Assessment:

COUNSELORS' NOTES