Elina Kincade/Medical Record

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< Elina Kincade
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Starfleet Medical.png

Elina Kincade

MEDICAL RECORD
  • Height: 5'5"
  • Weight: 135 lbs
  • Blood Type: O+
  • T/E Rating: T0/E0

PAST MEDICAL HISTORY

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

PAST HOSPITALIZATIONS/SERIOUS ILLNESS

PAST SURGICAL HISTORY

PSYCHIATRIC HISTORY

None

SUBSTANCE USE HISTORY

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

FAMILY MEDICAL HISTORY

  • Parent 1 (Mother): None
  • Parent 2 (Father): None
  • Siblings: None

SOCIAL HISTORY

  • Marital status: Single
  • Children:
  • Occupation/Assignment:
  • Diet:
  • Exercise:

PHYSICIANS' NOTES

  • SD xxxxxx.xx - Medical Officer:
  • Physical Assessment

COUNSELORS' NOTES

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