Chythar Skyfire/Medical History: Difference between revisions

Revision as of 00:05, 5 May 2014

	SKYFIRE, CHYTHAR DANIEL Patient Reference Number:198-461-762 Date of Birth:236207.06 Age: 39 Sex:M Species:Human
		MEDICAL RECORD
	Height: 167.64 cm (5'5" in) Weight: 65 kilos (143.30 lbs) Blood Type: B+ (B Positive)
	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 3: / Line 3: @@
 |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===
+===SKYFIRE, CHYTHAR DANIEL===
-*'''Patient Reference Number:''' 123-456-789
+*'''Patient Reference Number:'''198-461-762
-*'''Date of Birth:'''
+*'''Date of Birth:'''236207.06
-**'''Age:''' {{age|2360|03|31}}
+**'''Age:''' {{age|2362|07|06}}
-*'''Sex:'''
+*'''Sex:'''M
-*'''Species:'''
+*'''Species:'''[[Human]]
 |-
 |style="background:teal; border-radius: 0 0 0 14px; border:0px solid #AFA3BF"|
@@ Line 16: / Line 16: @@
 |style="background:teal; border-radius: 14px 0 0 0; border:0px solid #AFA3BF"|
 |colspan=2|
-*'''Height:''' 178 cm (5'10")
+*'''Height:''' 167.64 cm (5'5" in)
-*'''Weight:''' 73 kilos (160 lbs)
+*'''Weight:''' 65 kilos (143.30 lbs)
-*'''Blood Type:'''
+*'''Blood Type:''' B+ (B Positive)
 |-
 |style="background:teal;"|
 |colspan=2|
 ===PAST MEDICAL HISTORY===
 *'''Chronic Illnesses:'''