Roshanara Rahman/Medical Record: Difference between revisions

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Revision as of 02:34, 5 May 2014

Starfleet Medical.png

RAHMAN, ROSHANARA

  • Patient Reference Number: 912-804-117
  • Date of Birth: 235612.15
    • Age: 44
  • Sex: Female
  • Species: Kriosian
MEDICAL RECORD
  • Height: 161 cm (5'3")
  • Weight: 56 kilos (123 lbs)
  • Blood Type: K3

PAST MEDICAL HISTORY

  • Chronic Illnesses: Neurodegenerative disease of unknown origin
  • Medications:
  • Allergies and Reactions:
  • Sexual/Reproductive History:

PAST HOSPITALIZATIONS/SERIOUS ILLNESS

PAST SURGICAL HISTORY

PSYCHIATRIC HISTORY

SUBSTANCE USE HISTORY

  • Alcohol: None
  • Recreation Drugs: None
  • Other:

FAMILY MEDICAL HISTORY

  • Mother: Unknown
  • Father: Unknown
  • Siblings: None

SOCIAL HISTORY

  • Marital status: Single
  • Children: None
  • Occupation/Assignment: Engineer
  • Diet: Kriosian nutritional supplement
  • Exercise:

PHYSICIANS' NOTES

COUNSELORS' NOTES

  • Counselor:
  • Psychological Assessment:
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