Debra Cross/Medical Record: Difference between revisions

Latest revision as of 19:42, 17 October 2015

	Cross, Debra Patient Reference Number: - - Date of Birth:235107.13 Age: 50 Sex: Female Species:Human
		MEDICAL RECORD
	Height: cm (5'3") Weight: kilos (135 lbs) Blood Type: O T/E Rating: -
	PAST MEDICAL HISTORY Chronic Illnesses: Medications: Allergies and Reactions: Sexual/Reproductive History:
	PAST HOSPITALIZATIONS/SERIOUS ILLNESS SD 237005.05: SD 237007.05: PAST SURGICAL HISTORY SD 237005.05: SD 237007.05:
	PSYCHIATRIC HISTORY SUBSTANCE USE HISTORY Alcohol: Recreation Drugs: Other:
	FAMILY MEDICAL HISTORY Mother: Father: Siblings:
	SOCIAL HISTORY Marital status: Children: Occupation/Assignment: Diet: Exercise:

	PHYSICIANS' NOTES Medical Officer: Medical Assessment:
	COUNSELORS' NOTES Counselor: Psychological Assessment:

@@ Line 1: / Line 1: @@
 {|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===
+===Cross, Debra===
-*'''[[StarFleet Serial Number Register|Patient Reference Number:]]''' EZ - 123 - 456
+*'''[[StarFleet Serial Number Register|Patient Reference Number:]]'''  - -
-*'''Date of Birth:'''
+*'''Date of Birth:'''235107.13
-**'''Age:''' {{age|2360|03|31}}
+**'''Age:''' {{age|2351|07|13}}
-*'''Sex:'''
+*'''Sex:''' Female
-*'''Species:'''
+*'''Species:'''[[Human]]
 |-
 |style="background:teal; border-radius: 0 0 0 14px; border:0px solid #AFA3BF"|
@@ Line 16: / Line 15: @@
 |style="background:teal; border-radius: 14px 0 0 0; border:0px solid #AFA3BF"|
 |colspan=2|
-*'''Height:''' 178 cm (5'10")
+*'''Height:'''  cm (5'3")
-*'''Weight:''' 73 kilos (160 lbs)
+*'''Weight:'''  kilos (135 lbs)
-*'''Blood Type:'''
+*'''Blood Type:''' O
-*'''[[T/E Rating]]:'''
+*'''[[T/E Rating]]:''' -
 |-
 |style="background:teal;"|
 |colspan=2|
 ===PAST MEDICAL HISTORY===
 *'''Chronic Illnesses:'''