Template:Medical Record/Example: Difference between revisions

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{{Medical Record LCARS
{{{{Medical Record LCARS
|SERIAL NUMBER= EZ - 123 - 456
|SERIAL NUMBER= HC-018-080
|BIRTHYEAR= 2363
|BIRTHYEAR= 2371
|BIRTHMONTH= 01
|BIRTHMONTH= 09
|BIRTHDATE= 01
|BIRTHDATE= 02
|SEX= Female
|SEX= Female
|SPECIES= [[Human]]
|SPECIES= [[Human]] / [[Centauran]]
|HEIGHT= 161 cm (5'3")
|HEIGHT= 1.67 m
|WEIGHT= 56 kilos (123 lbs)
|WEIGHT= 54 kg
|BLOOD TYPE= B+
|BLOOD TYPE= AB positive
|T/E RATING= T0
|T/E RATING= T0/E0
|CHRONIC ILLNESSES= None
|CHRONIC ILLNESSES= None
|MEDICATIONS= None
|MEDICATIONS= Receiving regular contraceptive injections
|ALLERGIES & REACTIONS= Strawberries (hives)
|ALLERGIES & REACTIONS= Possible intolerance for certain grains (i.e. hops)
|SEXUAL/REPRODUCTIVE HISTORY= Longterm male partner
|SEXUAL/REPRODUCTIVE HISTORY= Active, no pregnancies
|PAST HOSPITALIZATIONS/SERIOUS ILLNESS=
|PAST HOSPITALIZATIONS/SERIOUS ILLNESS=
*'''2388:''' Tarkalean flu
*None
|PAST SURGICAL HISTORY=
|PAST SURGICAL HISTORY=
*'''SD 238911.12:''' Knee surgery
*'''2371''': At birth, left leg amputation (due to complications)
**'''Surgeon:''' {{n|Niccolò|del Vedova}}, MD
*'''2372''': At 8 months, bioelectrical implantation for neurologically-controlled prosthesis
**'''OR Site:''' {{USS|Mercury}}
*'''2390''': At 19 years, wisdom teeth removal
**'''Op Note:''' Link to sim
|PSYCHIATRIC HISTORY=  
|PSYCHIATRIC HISTORY= None
*None, regular counselling
|ALCOHOL USE= 2 glasses of wine per week
|ALCOHOL USE= Occasional
|RECREATIONAL DRUG USE= None
|RECREATIONAL DRUG USE= None
|OTHER SUBSTANCE USE= None
|OTHER SUBSTANCE USE= Mild caffeine intake
|MOTHER MEDICAL HISTORY= None
|PARENT 1 = Birth Mother
|FATHER MEDICAL HISTORY= Cardiovascular disease
|PARENT 1 MEDICAL HISTORY= Melissa Hopper (Human),  civilian file not available without requisition
|SIBLING MEDICAL HISTORY= None
|PARENT 2 = Biological Mother
|MARITAL STATUS & SPOUSE= Married to Elliot Smith
|PARENT 2 MEDICAL HISTORY= Ansyra Hopper (Centauran), civilian file not available without requisition
|CHILDREN= 1 son
|SIBLING MEDICAL HISTORY= Kerilyn Hopper (Human/Centauran), civilian file not available without requisition
|OCCUPATION= Helmsman
|MARITAL STATUS & SPOUSE= Single
|CHILDREN= None
|OCCUPATION= Chief Science Officer, [[Amity Outpost]]
|DIET= Vegetarian
|DIET= Vegetarian
|EXERCISE= Running, 3 times a week
|EXERCISE= Typical aerobics, cardiovascular health optimal
|PHYSICIANS NOTE=
|PHYSICIANS NOTE=
*'''SD 239004.23 - Medical Officer:''' {{n|Niccolò|del Vedova}}, MD, {{USS|Mercury}}
*'''239708.11 - Dr. Duran Larx''' (CMO, [[USS Wall Street]]): Ensign Hopper's health is excellent; Routine check-ups recommended.
*'''Medical Assessment:''' Ensign Smith is a 27-year-old human female who presents with abdominal pain and generalized weakness. She states the symptoms began last Thursday after eating a bowl of Commander McLaughin's "Sweet Chili Surprise" at the ship's annual cook off contest. I've started her on an intense bowel cleansing therapy which should be followed to completion through next week.
*
<hr>
*'''SD 239004.27 - Medical Officer:''' {{n|Niccolò|del Vedova}}, MD, {{USS|Mercury}}
*'''Addendum:''' Ensign Smith returned to sickbay today stating she felt much better, insisting that her cleansing therapy was no longer necessary. I told her nonsense and sent her on her way.
|COUNSELORS NOTE=
|COUNSELORS NOTE=
*'''SD 239004.28 - Counselor:''' Lt. Rachel Simmons, {{USS|Mercury}}
* None on file
*'''Counseling Assessment:''' Ensign Smith came to my office today in tears. It seems her recent medical illness due to her unfortunate encounter with McLaughlin's chili has left her feeling vulnerable and alone. I have advised her to continue daily therapy sessions with me until further notice.
}}
}}
</pre>
</pre>


{{Medical Record LCARS
{{Medical Record LCARS
|SERIAL NUMBER= EZ - 123 - 456
|SERIAL NUMBER= HC-018-080
|BIRTHYEAR= 2363
|BIRTHYEAR= 2371
|BIRTHMONTH= 01
|BIRTHMONTH= 09
|BIRTHDATE= 01
|BIRTHDATE= 02
|SEX= Female
|SEX= Female
|SPECIES= [[Human]]
|SPECIES= [[Human]] / [[Centauran]]
|HEIGHT= 161 cm (5'3")
|HEIGHT= 1.67 m
|WEIGHT= 56 kilos (123 lbs)
|WEIGHT= 54 kg
|BLOOD TYPE= B+
|BLOOD TYPE= AB positive
|T/E RATING= T0
|T/E RATING= T0/E0
|CHRONIC ILLNESSES= None
|CHRONIC ILLNESSES= None
|MEDICATIONS= None
|MEDICATIONS= Receiving regular contraceptive injections
|ALLERGIES & REACTIONS= Strawberries (hives)
|ALLERGIES & REACTIONS= Possible intolerance for certain grains (i.e. hops)
|SEXUAL/REPRODUCTIVE HISTORY= Longterm male partner
|SEXUAL/REPRODUCTIVE HISTORY= Active, no pregnancies
|PAST HOSPITALIZATIONS/SERIOUS ILLNESS=
|PAST HOSPITALIZATIONS/SERIOUS ILLNESS=
*'''2388:''' Tarkalean flu
*None
|PAST SURGICAL HISTORY=
|PAST SURGICAL HISTORY=
*'''SD 238911.12:''' Knee surgery
*'''2371''': At birth, left leg amputation (due to complications)
**'''Surgeon:''' {{n|Niccolò|del Vedova}}, MD
*'''2372''': At 8 months, bioelectrical implantation for neurologically-controlled prosthesis
**'''OR Site:''' {{USS|Mercury}}
*'''2390''': At 19 years, wisdom teeth removal
**'''Op Note:''' Link to sim
|PSYCHIATRIC HISTORY=  
|PSYCHIATRIC HISTORY= None
*None, regular counselling
|ALCOHOL USE= 2 glasses of wine per week
|ALCOHOL USE= Occasional
|RECREATIONAL DRUG USE= None
|RECREATIONAL DRUG USE= None
|OTHER SUBSTANCE USE= None
|OTHER SUBSTANCE USE= Mild caffeine intake
|MOTHER MEDICAL HISTORY= None
|PARENT 1 = Birth Mother
|FATHER MEDICAL HISTORY= Cardiovascular disease
|PARENT 1 MEDICAL HISTORY= Melissa Hopper (Human),  civilian file not available without requisition
|SIBLING MEDICAL HISTORY= None
|PARENT 2 = Biological Mother
|MARITAL STATUS & SPOUSE= Married to Elliot Smith
|PARENT 2 MEDICAL HISTORY= Ansyra Hopper (Centauran), civilian file not available without requisition
|CHILDREN= 1 son
|SIBLING MEDICAL HISTORY= Kerilyn Hopper (Human/Centauran), civilian file not available without requisition
|OCCUPATION= Helmsman
|MARITAL STATUS & SPOUSE= Single
|CHILDREN= None
|OCCUPATION= Chief Science Officer, [[Amity Outpost]]
|DIET= Vegetarian
|DIET= Vegetarian
|EXERCISE= Running, 3 times a week
|EXERCISE= Typical aerobics, cardiovascular health optimal
|PHYSICIANS NOTE=
|PHYSICIANS NOTE=
*'''SD 239004.23 - Medical Officer:''' {{n|Niccolò|del Vedova}}, MD, {{USS|Mercury}}
*'''239708.11 - Dr. Duran Larx''' (CMO, [[USS Wall Street]]): Ensign Hopper's health is excellent; Routine check-ups recommended.
*'''Medical Assessment:''' Ensign Smith is a 27-year-old human female who presents with abdominal pain and generalized weakness. She states the symptoms began last Thursday after eating a bowl of Commander McLaughin's "Sweet Chili Surprise" at the ship's annual cook off contest. I've started her on an intense bowel cleansing therapy which should be followed to completion through next week.
*
<hr>
*'''SD 239004.27 - Medical Officer:''' {{n|Niccolò|del Vedova}}, MD, {{USS|Mercury}}
*'''Addendum:''' Ensign Smith returned to sickbay today stating she felt much better, insisting that her cleansing therapy was no longer necessary. I told her nonsense and sent her on her way.
|COUNSELORS NOTE=
|COUNSELORS NOTE=
*'''SD 239004.28 - Counselor:''' Lt. Rachel Simmons, {{USS|Mercury}}
* None on file
*'''Counseling Assessment:''' Ensign Smith came to my office today in tears. It seems her recent medical illness due to her unfortunate encounter with McLaughlin's chili has left her feeling vulnerable and alone. I have advised her to continue daily therapy sessions with me until further notice.
}}
}}

Revision as of 09:59, 30 September 2022

{{{{Medical Record LCARS
|SERIAL NUMBER= HC-018-080
|BIRTHYEAR= 2371
|BIRTHMONTH= 09
|BIRTHDATE= 02
|SEX= Female
|SPECIES= [[Human]] / [[Centauran]]
|HEIGHT= 1.67 m
|WEIGHT= 54 kg
|BLOOD TYPE= AB positive
|T/E RATING= T0/E0
|CHRONIC ILLNESSES= None
|MEDICATIONS= Receiving regular contraceptive injections
|ALLERGIES & REACTIONS= Possible intolerance for certain grains (i.e. hops)
|SEXUAL/REPRODUCTIVE HISTORY= Active, no pregnancies
|PAST HOSPITALIZATIONS/SERIOUS ILLNESS=
*None
|PAST SURGICAL HISTORY=
*'''2371''': At birth, left leg amputation (due to complications)
*'''2372''': At 8 months, bioelectrical implantation for neurologically-controlled prosthesis
*'''2390''': At 19 years, wisdom teeth removal
|PSYCHIATRIC HISTORY= 
*None, regular counselling
|ALCOHOL USE= Occasional
|RECREATIONAL DRUG USE= None
|OTHER SUBSTANCE USE= Mild caffeine intake
|PARENT 1 = Birth Mother
|PARENT 1 MEDICAL HISTORY= Melissa Hopper (Human),  civilian file not available without requisition
|PARENT 2 = Biological Mother
|PARENT 2 MEDICAL HISTORY= Ansyra Hopper (Centauran), civilian file not available without requisition
|SIBLING MEDICAL HISTORY= Kerilyn Hopper (Human/Centauran), civilian file not available without requisition
|MARITAL STATUS & SPOUSE= Single
|CHILDREN= None
|OCCUPATION= Chief Science Officer, [[Amity Outpost]]
|DIET= Vegetarian
|EXERCISE= Typical aerobics, cardiovascular health optimal
|PHYSICIANS NOTE=
*'''239708.11 - Dr. Duran Larx''' (CMO, [[USS Wall Street]]): Ensign Hopper's health is excellent; Routine check-ups recommended.
*
|COUNSELORS NOTE=
* None on file
}}
Starfleet Medical.png

Medical Record

MEDICAL RECORD
  • Height: 1.67 m
  • Weight: 54 kg
  • Blood Type: AB positive
  • T/E Rating: T0/E0

PAST MEDICAL HISTORY

  • Chronic Illnesses: None
  • Medications: Receiving regular contraceptive injections
  • Allergies and Reactions: Possible intolerance for certain grains (i.e. hops)
  • Sexual/Reproductive History: Active, no pregnancies

PAST HOSPITALIZATIONS/SERIOUS ILLNESS

  • None

PAST SURGICAL HISTORY

  • 2371: At birth, left leg amputation (due to complications)
  • 2372: At 8 months, bioelectrical implantation for neurologically-controlled prosthesis
  • 2390: At 19 years, wisdom teeth removal

PSYCHIATRIC HISTORY

  • None, regular counselling

SUBSTANCE USE HISTORY

  • Alcohol: Occasional
  • Recreation Drugs: None
  • Other: Mild caffeine intake

FAMILY MEDICAL HISTORY

  • Parent 1 (Birth Mother): Melissa Hopper (Human), civilian file not available without requisition
  • Parent 2 (Biological Mother): Ansyra Hopper (Centauran), civilian file not available without requisition
  • Siblings: Kerilyn Hopper (Human/Centauran), civilian file not available without requisition

SOCIAL HISTORY

  • Marital status: Single
  • Children: None
  • Occupation/Assignment: Chief Science Officer, Amity Outpost
  • Diet: Vegetarian
  • Exercise: Typical aerobics, cardiovascular health optimal

PHYSICIANS' NOTES

  • 239708.11 - Dr. Duran Larx (CMO, USS Wall Street): Ensign Hopper's health is excellent; Routine check-ups recommended.

COUNSELORS' NOTES

  • None on file


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