Tu'Peq/Medical Record

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TU'PEQ

Service Record Personal Life Medical Record Academy Transcript MEDICAL RECORD
  • Date of Birth: 234203.4
    • Age: 59
  • Sex: Male
  • Species: Vulcan
  • Height: 182 cm
  • Weight: 72 kg
  • Blood Type: B-

PAST MEDICAL HISTORY

  • Chronic Illnesses: Acute Asthma
  • Medications: Inhaled corticosteroids
  • Allergies and Reactions: Asthma
  • Sexual/Reproductive History:

PAST HOSPITALIZATIONS/SERIOUS ILLNESS

PAST SURGICAL HISTORY

PSYCHIATRIC HISTORY

SUBSTANCE USE HISTORY

  • Alcohol: Frequent use, at risk of addiction.
  • Recreation Drugs: None
  • Other: None

FAMILY MEDICAL HISTORY

  • Mother:
  • Father:
  • Siblings:

SOCIAL HISTORY

  • Marital status: Single
  • Children: None
  • Occupation/Assignment: Helm & Navigational Officer, USS Apollo
  • Diet:
  • Exercise:

PHYSICIANS' NOTES

COUNSELORS' NOTES

  • Counselor:
  • Psychological Assessment:
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