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LAST NAME, FIRST NAME MIDDLE NAME
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MEDICAL RECORD
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- Height: 170.7 cm (5'6")
- Weight: 63.5 kilos (140 lbs)
- Blood Type: O Negative
- T/E Rating: 0
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PAST MEDICAL HISTORY
- Chronic Illnesses: L. Avery has no known long-term, chronic illnesses or medical maladies.
- Medications: Standard Starfleet Immuno-Hypospray received annually. No other medications on file.
- Allergies and Reactions: NOTE: SEVERE allergic reaction to Bajoran homeopathic medical treatment. This is likely due to a specific reaction to Makara Root, although all local medicinal remedies should be avoided due to cross-contamination concerns.
- Sexual/Reproductive History: L. Avery has identified as sexually active. L. Avery has no known reproductive history.
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PAST HOSPITALIZATIONS/SERIOUS ILLNESS
- SD 238910.17:
- While on outdoor, planetary survival excursion L. Avery was diagnosed with Terran Pneumonia following long-term exposure to temperatures below -1 degrees Celsius in high-humidity conditions. Upon conclusion of excursion, L. Avery had been ill approximately four days. Chemotherapeutic treatment with multi-hypospray antibiotics alleviated condition within five more days.
PAST SURGICAL HISTORY
- SD 237502.24:
- As a child, L. Avery underwent outpatient surgery to remove her appendix. Surgery was performed at the Federation Civilian Hospital, San Francisco, Earth. There were no complications reported.
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PSYCHIATRIC HISTORY
SUBSTANCE USE HISTORY
- Alcohol: L. Avery reports limited to moderate alcohol consumption, consisting of 3-5 drinks per week.
- Recreation Drugs: L. Avery reports no current or prior use of any recreational drugs. L. Avery has never given positive indication on any Starfleet drug test.
- Other: L. Avery reports above-average caffeine consumption, primarily through liquid intake consisting of Terran coffee and Klingon Raktajino. There have been no negative side-effects reported by the patient.
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FAMILY MEDICAL HISTORY
- Mother: Mother, J. Avery, suffers from an ovulatory condition which caused near-complete infertility. Extensive IVF treatment was required for reproduction, and L. Avery reports the mother had numerous failed IVF treatment sessions as well. As a genetic condition, L. Avery is likely to experience similar difficulties.
- Father: Father, P. Avery, sought treatment twice for alcoholism in the 2360s. Early-age high blood-pressure also reported (a link between the two is likely).
- Siblings: L. Avery has no siblings.
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SOCIAL HISTORY
- Marital status: L. Avery is single and reports no long-term romantic involvement.
- Children: L. Avery has no children, biological or otherwise.
- Occupation/Assignment:
- L. Avery was assigned to Starfleet Academy, San Francisco, Earth between 238708.01 - 239105.12. Patient reports a focus on Engineering and Physics. Concerns are exposure to plasma, high-yield energy fields, and mechanical instruments.
- L. Avery was posted to the USS Vigilant-A on SD 239105.14 as an Engineering Officer. Same concerns as above, with an increased focus on electromagnetic fields and plasma from warp core. The vessel is capable of quantum slipstream travel - same annual testing requirements as other exposed crew are recommended for long-term research data.
- Diet: Patient reports a primarily Terran diet, augmented by Vulcan and Bajoran cuisines. Nothing the patient reports as a regular part of her diet is known to cause dietary or other health issues for a Terran.
- Exercise: Patient reports moderate exercise (2-6 hours per week) consisting of hiking and light jogging primarily in a holodeck environment. Patient has previously reported minor ankle pain as the result of a jogging injury (soft tissue and bone scans negative for serious damage). Significant stretching and post-exercise icing recommended.
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PHYSICIANS' NOTES
- Medical Officer:
- Medical Assessment:
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COUNSELORS' NOTES
- Counselor:
- Psychological Assessment:
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