Ben Livingston/Medical Record: Difference between revisions

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(Created page with "{{subst:Medical Record}} Category:Ben Livingston Category:Medical Records")
 
m (Rich moved page Livingston, Benjamin/Medical Record to Ben Livingston/Medical Record: new wiki naming convention)
 
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|width="600" colspan=2|[[File:Starfleet Medical.png|right|150px|link=Category:Medical Records]]
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===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}}
**'''Age:''' {{age|2360|03|31}}
*'''Sex:'''
*'''Sex:''' Male
*'''Species:'''
*'''Species:''' Terran
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*'''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
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===PAST MEDICAL HISTORY===
===PAST MEDICAL HISTORY===
*'''Chronic Illnesses:'''
*'''Chronic Illnesses:''' None
*'''Medications:'''
*'''Medications:''' None
*'''Allergies and Reactions:'''
*'''Allergies and Reactions:''' None
*'''Sexual/Reproductive History:'''
*'''Sexual/Reproductive History:'''
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===PAST HOSPITALIZATIONS/SERIOUS ILLNESS===
===PAST HOSPITALIZATIONS/SERIOUS ILLNESS===
*'''SD 237005.05:'''
*'''SD 239006.02:''' Severe concussion with accompanying memory loss. Sustained during explosion. Other conditions treated included lacerations and hearing loss.
*'''SD 237007.05:'''
*'''SD 237007.05:''' Injured during fall. Fractured tibia, treated for exhaustion.


===PAST SURGICAL HISTORY===
===PAST SURGICAL HISTORY===
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===SUBSTANCE USE HISTORY===
===SUBSTANCE USE HISTORY===
*'''Alcohol:'''
*'''Alcohol:''' Occasional use
*'''Recreation Drugs:'''
*'''Recreation Drugs:''' None
*'''Other:'''
*'''Other:''' None
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===FAMILY MEDICAL HISTORY===
===FAMILY MEDICAL HISTORY===
*'''Mother:'''
*'''Mother:'''
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===SOCIAL HISTORY===
===SOCIAL HISTORY===
*'''Marital status:'''
*'''Marital status:''' Single
*'''Children:'''
*'''Children:''' None
*'''Occupation/Assignment:'''
*'''Occupation/Assignment:''' First Officer
*'''Diet:'''
*'''Diet:'''
*'''Exercise:'''
*'''Exercise:''' Jogs regularly
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===PHYSICIANS' NOTES===
===PHYSICIANS' NOTES===
*'''Medical Officer:'''
*'''Medical Officer:'''

Latest revision as of 20:54, 3 January 2016

Starfleet Medical.png

LIVINGSTON, BENJAMIN HAROLD

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: None
  • Medications: None
  • Allergies and Reactions: None
  • Sexual/Reproductive History:

PAST HOSPITALIZATIONS/SERIOUS ILLNESS

  • SD 239006.02: Severe concussion with accompanying memory loss. Sustained during explosion. Other conditions treated included lacerations and hearing loss.
  • SD 237007.05: Injured during fall. Fractured tibia, treated for exhaustion.

PAST SURGICAL HISTORY

  • SD 237005.05:
  • SD 237007.05:

PSYCHIATRIC HISTORY

SUBSTANCE USE HISTORY

  • Alcohol: Occasional use
  • Recreation Drugs: None
  • Other: None

FAMILY MEDICAL HISTORY

  • Mother:
  • Father:
  • Siblings:

SOCIAL HISTORY

  • Marital status: Single
  • Children: None
  • Occupation/Assignment: First Officer
  • Diet:
  • Exercise: Jogs regularly

PHYSICIANS' NOTES

  • Medical Officer:
  • Medical Assessment:

COUNSELORS' NOTES

  • Counselor:
  • Psychological Assessment:
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