Patrick McLeod/Medical Record: Difference between revisions

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{{McLeod
|Color=Teal
|Section Name=MEDICAL RECORD
|Section Name Width=170
}}


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{|style="max-width:2000"  
|style="background:teal;" width="100"|
|style="background:teal; border-radius: 14px 0 0 0; border:0px solid #AFA3BF" width="100"|
|width="600" colspan=2|[[File:Starfleet Medical.png|right|150px|link=Category:Medical Records]]
===LAST NAME, FIRST NAME MIDDLE NAME===
*'''[[StarFleet Serial Number Register|Patient Reference Number:]]''' EZ - 123 - 456
*'''Date of Birth:'''
**'''Age:''' {{age|2360|03|31}}
*'''Sex:'''
*'''Species:'''
|-
|style="background:teal; border-radius: 0 0 0 14px; border:0px solid #AFA3BF"|
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!width=180 align=right|<font size="4" color=teal>MEDICAL RECORD</font>
|-
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|colspan=2|
|colspan=2|
*'''Height:''' 178 cm (5'10")
*'''Date of Birth:''' 236503.11
*'''Weight:''' 73 kilos (160 lbs)
**'''Age:''' {{age|2365|03|11}}
*'''Blood Type:'''
*'''Sex:''' Male
*'''[[T/E Rating]]:'''
*'''Species:''' Terran
*'''Height:''' 182 cm
*'''Weight:''' 72 kg
*'''Blood Type:''' B-
|-
|-
|style="background:teal;"|
|style="background:teal;"|
|colspan=2|
|colspan=2|
===PAST MEDICAL HISTORY===
===PAST MEDICAL HISTORY===
*'''Chronic Illnesses:'''
*'''Chronic Illnesses:''' Acute Asthma
*'''Medications:'''
*'''Medications:''' Inhaled corticosteroids
*'''Allergies and Reactions:'''
*'''Allergies and Reactions:''' Asthma
*'''Sexual/Reproductive History:'''
*'''Sexual/Reproductive History:'''
|-
|-
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|colspan=2|
===PAST HOSPITALIZATIONS/SERIOUS ILLNESS===
===PAST HOSPITALIZATIONS/SERIOUS ILLNESS===
*'''SD 237005.05:'''
*'''SD 237007.05:'''


===PAST SURGICAL HISTORY===
===PAST SURGICAL HISTORY===
*'''SD 237005.05:'''
*'''SD 237007.05:'''
|-
|-
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===SUBSTANCE USE HISTORY===
===SUBSTANCE USE HISTORY===
*'''Alcohol:'''
*'''Alcohol:''' Frequent use, at risk of addiction.
*'''Recreation Drugs:'''
*'''Recreation Drugs:''' None
*'''Other:'''
*'''Other:''' None
|-
|-
|style="background:teal;"|
|style="background:teal;"|
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|colspan=2|
===FAMILY MEDICAL HISTORY===
===FAMILY MEDICAL HISTORY===
*'''Mother:'''
*'''Mother:'''
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|colspan=2|
===SOCIAL HISTORY===
===SOCIAL HISTORY===
*'''Marital status:'''
*'''Marital status:''' Single
*'''Children:'''
*'''Children:''' None
*'''Occupation/Assignment:'''
*'''Occupation/Assignment:''' Helm & Navigational Officer, [[USS Apollo]]
*'''Diet:'''
*'''Diet:'''
*'''Exercise:'''
*'''Exercise:'''
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===PHYSICIANS' NOTES===
===PHYSICIANS' NOTES===
*'''Medical Officer:'''
*'''Medical Officer:''' [[Laxyn, Jalana|Lt. Commander Jalana Laxyn]], MD, [[USS Apollo]]
*'''Medical Assessment:'''
*'''Medical Assessment:'''
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__NOTOC__
__NOTOC__
[[Category:Medical Records]]
[[Category:Medical Records]]
[[Category:Patrick McLeod]]

Latest revision as of 00:13, 30 July 2017

Main Page
McLeod.jpg

McLEOD, PATRICK

Service Record Personal Life Medical Record Academy Transcript MEDICAL RECORD
  • Date of Birth: 236503.11
    • Age: 36
  • Sex: Male
  • Species: Terran
  • Height: 182 cm
  • Weight: 72 kg
  • Blood Type: B-

PAST MEDICAL HISTORY

  • Chronic Illnesses: Acute Asthma
  • Medications: Inhaled corticosteroids
  • Allergies and Reactions: Asthma
  • Sexual/Reproductive History:

PAST HOSPITALIZATIONS/SERIOUS ILLNESS

PAST SURGICAL HISTORY

PSYCHIATRIC HISTORY

SUBSTANCE USE HISTORY

  • Alcohol: Frequent use, at risk of addiction.
  • Recreation Drugs: None
  • Other: None

FAMILY MEDICAL HISTORY

  • Mother:
  • Father:
  • Siblings:

SOCIAL HISTORY

  • Marital status: Single
  • Children: None
  • Occupation/Assignment: Helm & Navigational Officer, USS Apollo
  • Diet:
  • Exercise:

PHYSICIANS' NOTES

COUNSELORS' NOTES

  • Counselor:
  • Psychological Assessment:
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