543
edits
No edit summary |
No edit summary |
||
Line 19: | Line 19: | ||
|colspan=2| | |colspan=2| | ||
===PAST MEDICAL HISTORY=== | ===PAST MEDICAL HISTORY=== | ||
*'''Chronic Illnesses:''' | *'''Chronic Illnesses:''' | ||
*'''Medications:''' | *'''Medications:''' | ||
*'''Allergies and Reactions:''' | *'''Allergies and Reactions:''' | ||
*'''Sexual/Reproductive History:''' | *'''Sexual/Reproductive History:''' | ||
|- | |- | ||
Line 35: | Line 35: | ||
===SUBSTANCE USE HISTORY=== | ===SUBSTANCE USE HISTORY=== | ||
*'''Alcohol:''' | *'''Alcohol:''' Occasional | ||
*'''Recreation Drugs:''' None | *'''Recreation Drugs:''' None | ||
*'''Other:''' None | *'''Other:''' None | ||
Line 52: | Line 52: | ||
*'''Marital status:''' Single | *'''Marital status:''' Single | ||
*'''Children:''' None | *'''Children:''' None | ||
*'''Occupation/Assignment:''' | *'''Occupation/Assignment:''' Science Officer, [[USS Blackwell]] | ||
*'''Diet:''' | *'''Diet:''' | ||
*'''Exercise:''' | *'''Exercise:''' | ||
Line 62: | Line 62: | ||
===PHYSICIANS' NOTES=== | ===PHYSICIANS' NOTES=== | ||
*'''Medical Officer:''' [[ | *'''Medical Officer:''' [[Anath_G%27Renn|Lieutenant JG Anath G'Renn]], [[USS Blackwell]] | ||
*'''Medical Assessment:''' | *'''Medical Assessment:''' | ||
|- | |- | ||
Line 68: | Line 68: | ||
|colspan=2| | |colspan=2| | ||
===COUNSELORS' NOTES=== | ===COUNSELORS' NOTES=== | ||
*'''Counselor:''' | *'''Counselor:''' [[Kalara_Avran| Lieutenant JG Kalara Avran]], [[USS Blackwell]] | ||
*'''Psychological Assessment:''' | *'''Psychological Assessment:''' | ||
|} | |} |
edits