Carter Greyson/Medical Record: Difference between revisions

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(added medical record template)
 
(Added basic info for Carter. Will be adding more later.)
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===LAST NAME, FIRST NAME MIDDLE NAME===
===GREYSON, CARTER===
*'''[[StarFleet Serial Number Register|Patient Reference Number:]]''' EZ - 123 - 456
*'''[[StarFleet Serial Number Register|Patient Reference Number:]]''' AZ - 159 - 930
*'''Date of Birth:'''
*'''Date of Birth:'''
**'''Age:''' {{age|2360|03|31}}
**'''Age:''' {{age|2369|07|06}}
*'''Sex:'''
*'''Sex:''' Male
*'''Species:'''
*'''Species:''' [[Terran]]
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*'''Height:''' 178 cm (5'10")
*'''Height:''' 6'2"
*'''Weight:''' 73 kilos (160 lbs)
*'''Weight:''' 75 kilos  
*'''Blood Type:'''
*'''Blood Type:''' AB Negative
*'''[[T/E Rating]]:'''
*'''[[T/E Rating]]:''' T0/E0
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===PAST MEDICAL HISTORY===
===PAST MEDICAL HISTORY===
*'''Chronic Illnesses:'''
*'''Chronic Illnesses:'''

Revision as of 06:28, 22 June 2014

Starfleet Medical.png

GREYSON, CARTER

MEDICAL RECORD
  • Height: 6'2"
  • Weight: 75 kilos
  • Blood Type: AB Negative
  • T/E Rating: T0/E0

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: