User:Noa T'Nessa Levinson/Sandbox5: Difference between revisions

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(Copying from Template:Medical Record LCARS for modification)
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<includeonly>{|style="max-width:700px"
<onlyinclude><noinclude>{{{NO INCLUDE|}}}</noinclude><includeonly>{{{INCLUDE ONLY|}}}</includeonly></onlyinclude><noinclude>[[Category:Adingo]]</noinclude>
|style="background:teal;" width="100"|
|width="600" colspan=2|[[File:Starfleet Medical.png|right|150px|link=Category:Medical Records]]
===<span style="text-transform:uppercase;">{{BASEPAGENAME}}</span>===
*'''[[StarFleet Serial Number Register|Patient Reference Number:]]''' {{{SERIAL NUMBER|}}}
*'''Date of Birth:''' {{{BIRTHYEAR|}}}{{{BIRTHMONTH|}}}.{{{BIRTHDATE|}}}
**'''Age:''' {{age|{{{BIRTHYEAR|}}}|{{{BIRTHMONTH|}}}|{{{BIRTHDATE|}}}}}
*'''Sex:''' {{{SEX|}}}
*'''Species:''' {{{SPECIES|}}}
|-
|style="background:teal; border-radius: 0 0 0 14px; border:0px solid #AFA3BF"|
|style="background:teal" |
!width=180 align=right style="line-height: 130%;"|<font size="4" color=teal>MEDICAL RECORD</font>
|-
|style="background:teal; border-radius: 14px 0 0 0; border:0px solid #AFA3BF"|
|colspan=2|
*'''Height:''' {{{HEIGHT|}}}
*'''Weight:''' {{{WEIGHT|}}}
*'''Blood Type:''' {{{BLOOD TYPE|}}}
*'''[[T/E Rating]]:''' {{{T/E RATING|}}}
|-
|style="background:teal;"|
|colspan=2|
===PAST MEDICAL HISTORY===
*'''Chronic Illnesses:''' {{{CHRONIC ILLNESSES|}}}
*'''Medications:''' {{{MEDICATIONS|}}}
*'''Allergies and Reactions:''' {{{ALLERGIES & REACTIONS|}}}
*'''Sexual/Reproductive History:''' {{{SEXUAL/REPRODUCTIVE HISTORY|}}}
|-
|style="background:teal;"|
|colspan=2|
===PAST HOSPITALIZATIONS/SERIOUS ILLNESS===
{{{PAST HOSPITALIZATIONS/SERIOUS ILLNESS|}}}
 
===PAST SURGICAL HISTORY===
{{{PAST SURGICAL HISTORY|}}}
|-
|style="background:teal;"|
|colspan=2|
===PSYCHIATRIC HISTORY===
{{{PSYCHIATRIC HISTORY|}}}
 
===SUBSTANCE USE HISTORY===
*'''Alcohol:''' {{{ALCOHOL USE|}}}
*'''Recreation Drugs:''' {{{RECREATIONAL DRUG USE|}}}
*'''Other:''' {{{OTHER SUBSTANCE USE|}}}
|-
|style="background:teal;"|
|colspan=2|
===FAMILY MEDICAL HISTORY===
*'''Mother:''' {{{MOTHER MEDICAL HISTORY|}}}
*'''Father:''' {{{FATHER MEDICAL HISTORY|}}}
*'''Siblings:''' {{{SIBLING MEDICAL HISTORY|}}}
|-
|style="background:teal;"|
|colspan=2|
===SOCIAL HISTORY===
*'''Marital status:''' {{{MARITAL STATUS & SPOUSE|}}}
*'''Children:''' {{{CHILDREN|}}}
*'''Occupation/Assignment:''' {{{OCCUPATION|}}}
*'''Diet:''' {{{DIET|}}}
*'''Exercise:''' {{{EXERCISE|}}}
|-
|style="background:teal;" colspan=3 height=4|
|-
|style="background:teal;"|
|colspan=2|
===PHYSICIANS' NOTES===
{{{PHYSICIANS NOTE|}}}
|-
|style="background:teal;" colspan=3 height=4|
|-
|style="background:teal;"|
|colspan=2|
===COUNSELORS' NOTES===
{{{COUNSELORS NOTE|}}}
|}
__NOEDITSECTION__
__NOTOC__
</includeonly>
<noinclude>[[Category:Adingo]]</noinclude>

Latest revision as of 15:17, 19 September 2023

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