Karynn Ehlanii Brice/Medical Record: Difference between revisions

Revision as of 15:04, 20 May 2014

	LAST NAME, FIRST NAME MIDDLE NAME Patient Reference Number: DJ-385-263 Date of Birth: 235704.08 Age: 34 Sex: Female Species: Haliian
		MEDICAL RECORD
	Height: 5'4" Weight: 125 lbs. Blood Type: Not Human T/E Rating: E3
	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 4: / Line 4: @@
 |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
+*'''[[StarFleet Serial Number Register|Patient Reference Number:]]''' DJ-385-263
-*'''Date of Birth:'''
+*'''Date of Birth:''' 235704.08
-**'''Age:''' {{age|2360|03|31}}
+**'''Age:''' 34
-*'''Sex:'''
+*'''Sex:''' Female
-*'''Species:'''
+*'''Species:''' Haliian
 |-
 |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:''' 5'4"
-*'''Weight:''' 73 kilos (160 lbs)
+*'''Weight:''' 125 lbs.
-*'''Blood Type:'''
+*'''Blood Type:''' Not Human
-*'''[[T/E Rating]]:'''
+*'''[[T/E Rating]]:''' E3
 |-
 |style="background:teal;"|
 |colspan=2|
 ===PAST MEDICAL HISTORY===
 *'''Chronic Illnesses:'''