Kimiko Chun/Medical Transcript: Difference between revisions

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===LAST NAME, FIRST NAME MIDDLE NAME===
===CHUN, KIMIKO REI===
*'''[[StarFleet Serial Number Register|Patient Reference Number:]]''' EZ - 123 - 456
*'''[[StarFleet Serial Number Register|Patient Reference Number:]]''' MT - 839 - 915
*'''Date of Birth:'''
*'''Date of Birth: 236610.20'''
**'''Age:''' {{age|2360|03|31}}
**'''Age: 25''' {{25|2366|10|20}}
*'''Sex:'''
*'''Sex: Female'''
*'''Species:'''
*'''Species: Betazoid'''
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*'''Height:''' 178 cm (5'10")
*'''Height:''' 164.5 cm (5'4")
*'''Weight:''' 73 kilos (160 lbs)
*'''Weight:''' 60.78 kilos (134 lbs)
*'''Blood Type:'''
*'''Blood Type: AB+'''
*'''[[T/E Rating]]:'''
*'''[[T/E Rating]]:'''
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===PAST MEDICAL HISTORY===
===PAST MEDICAL HISTORY===
*'''Chronic Illnesses:'''
*'''Chronic Illnesses: N/A'''
*'''Medications:'''
*'''Medications: N/A'''
*'''Allergies and Reactions:'''
*'''Allergies and Reactions: N/A'''
*'''Sexual/Reproductive History:'''
*'''Sexual/Reproductive History: N/A'''
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===PAST HOSPITALIZATIONS/SERIOUS ILLNESS===
===PAST HOSPITALIZATIONS/SERIOUS ILLNESS===
*'''SD 237005.05:'''
 
*'''SD 237007.05:'''


===PAST SURGICAL HISTORY===
===PAST SURGICAL HISTORY===
*'''SD 237005.05:'''
 
*'''SD 237007.05:'''
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===SUBSTANCE USE HISTORY===
===SUBSTANCE USE HISTORY===
*'''Alcohol:'''
*'''Alcohol: N/A'''
*'''Recreation Drugs:'''
*'''Recreation Drugs: N/A'''
*'''Other:'''
*'''Other: N/A'''
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===FAMILY MEDICAL HISTORY===
===FAMILY MEDICAL HISTORY===
*'''Mother:'''
*'''Mother: Akira Chun'''
*'''Father:'''
*'''Father: Reijirou Chun'''
*'''Siblings:'''
*'''Siblings: Makaso Chun (deceased)'''
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===SOCIAL HISTORY===
===SOCIAL HISTORY===
*'''Marital status:'''
*'''Marital status: Single'''
*'''Children:'''
*'''Children: None'''
*'''Occupation/Assignment:'''
*'''Occupation/Assignment: Counsellor'''
*'''Diet:'''
*'''Diet: Normal'''
*'''Exercise:'''
*'''Exercise: Normal'''
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Revision as of 02:37, 1 June 2014

Starfleet Medical.png

CHUN, KIMIKO REI

MEDICAL RECORD
  • Height: 164.5 cm (5'4")
  • Weight: 60.78 kilos (134 lbs)
  • Blood Type: AB+
  • T/E Rating:

PAST MEDICAL HISTORY

  • Chronic Illnesses: N/A
  • Medications: N/A
  • Allergies and Reactions: N/A
  • Sexual/Reproductive History: N/A

PAST HOSPITALIZATIONS/SERIOUS ILLNESS

PAST SURGICAL HISTORY

PSYCHIATRIC HISTORY

SUBSTANCE USE HISTORY

  • Alcohol: N/A
  • Recreation Drugs: N/A
  • Other: N/A

FAMILY MEDICAL HISTORY

  • Mother: Akira Chun
  • Father: Reijirou Chun
  • Siblings: Makaso Chun (deceased)

SOCIAL HISTORY

  • Marital status: Single
  • Children: None
  • Occupation/Assignment: Counsellor
  • Diet: Normal
  • Exercise: Normal

PHYSICIANS' NOTES

  • Medical Officer:
  • Medical Assessment:

COUNSELORS' NOTES

  • Counselor:
  • Psychological Assessment:
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