Colleen Bancroft/Medical Record

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Colleen Bancroft

MEDICAL RECORD
  • Height: 1.65 meters (5'5")
  • Weight: 65.3 kg (144 lbs.)
  • Blood Type: O-
  • T/E Rating: T0/E0

PAST MEDICAL HISTORY

  • Chronic Illnesses: None
  • Medications: None
  • Allergies and Reactions: N/A
  • Sexual/Reproductive History:

PAST HOSPITALIZATIONS/SERIOUS ILLNESS

PAST SURGICAL HISTORY

PSYCHIATRIC HISTORY

SUBSTANCE USE HISTORY

  • Alcohol:
  • Recreation Drugs: None
  • Other: None

FAMILY MEDICAL HISTORY

  • Siblings:

SOCIAL HISTORY

  • Marital status: N/A
  • Children: None
  • Occupation/Assignment:
  • Diet: Standard
  • Exercise:

PHYSICIANS' NOTES

COUNSELORS' NOTES