Varu Novin/Medical Record: Difference between revisions

Revision as of 20:11, 10 August 2014

	VARU, NOVIN Patient Reference Number: DE - 959 - 746 Date of Birth: 236404.08 Age: 37 Sex: Male Species: Bajoran/Trill-Hybrid
		MEDICAL RECORD
	Height: 180 cm (5'11") Weight: 75 kilos (165 lbs) Blood Type: T/E Rating: T0/E0
	PAST MEDICAL HISTORY Chronic Illnesses: Medications: Allergies and Reactions: Sexual/Reproductive History:
	PAST HOSPITALIZATIONS/SERIOUS ILLNESS None PAST SURGICAL HISTORY None
	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===
+===VARU, NOVIN===
-*'''[[StarFleet Serial Number Register|Patient Reference Number:]]''' EZ - 123 - 456
+*'''[[StarFleet Serial Number Register|Patient Reference Number:]]''' DE - 959 - 746
-*'''Date of Birth:'''
+*'''Date of Birth:''' 236404.08
-**'''Age:''' {{age|2360|03|31}}
+**'''Age:''' {{age|2364|04|08}}
-*'''Sex:'''
+*'''Sex:''' Male
-*'''Species:'''
+*'''Species:''' [[Bajoran]]/[[Trill]]-Hybrid
 |-
 |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:''' 180 cm (5'11")
-*'''Weight:''' 73 kilos (160 lbs)
+*'''Weight:''' 75 kilos (165 lbs)
 *'''Blood Type:'''
-*'''[[T/E Rating]]:'''
+*'''[[T/E Rating]]:''' T0/E0
 |-
 |style="background:teal;"|
@@ Line 32: / Line 32: @@
 |colspan=2|
 ===PAST HOSPITALIZATIONS/SERIOUS ILLNESS===
-*'''SD 237005.05:'''
+*'''None'''
-*'''SD 237007.05:'''
 ===PAST SURGICAL HISTORY===
-*'''SD 237005.05:'''
+*'''None'''
-*'''SD 237007.05:'''
 |-
 |style="background:teal;"|