Alexander Richards/Medical Reports: Difference between revisions

Revision as of 01:28, 8 May 2014

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	LAST NAME, FIRST NAME MIDDLE NAME Patient Reference Number: EZ - 123 - 456 Date of Birth: Age: 41 Sex: Species:
		MEDICAL RECORD
	Height: 178 cm (5'10") Weight: 73 kilos (160 lbs) Blood Type: T/E Rating:
	PAST MEDICAL HISTORY Chronic Illnesses: Medications: Allergies and Reactions: Sexual/Reproductive History:
	PAST HOSPITALIZATIONS/SERIOUS ILLNESS SD 237005.05: SD 237007.05: PAST SURGICAL HISTORY SD 237005.05: SD 237007.05:
	PSYCHIATRIC HISTORY SUBSTANCE USE HISTORY Alcohol: Recreation Drugs: Other:
	FAMILY MEDICAL HISTORY Mother: Father: Siblings:
	SOCIAL HISTORY Marital status: Children: Occupation/Assignment: Diet: Exercise:

	PHYSICIANS' NOTES Medical Officer: Medical Assessment:
	COUNSELORS' NOTES Counselor: Psychological Assessment:

NPC Listing · USS Gemini Crew Manifest · Crew History


Captain Liam Frost


First Officer Alex Blair


Science Officer Alana Larson


Science Officer Alexander Richards


Counselor Lan Riel


Medical Officer Kali Nicholotti


Intel Officer Oliver Weston


Mission Spec. T'Mar


Helm Officer Randal Shayne


Engineering Officer Inde


Chief of Security Nemitor Atimen


Security Officer Jonhar Mayne


Tactical Officer Gina EsAleh


Tactical Officer Stephanie Moore

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@@ Line 2: / Line 2: @@
 {{UnderConstruction|Alexander Richards}}
 {{Richards Main}}
+{|style="max-width:700px"
+|style="background:teal;" width="100"|
+|width="600" colspan=2|[[File:Starfleet Medical.png|right|150px|link=Category:Medical Records]]
+===LAST NAME, FIRST NAME MIDDLE NAME===
+*'''[[StarFleet Serial Number Register|Patient Reference Number:]]''' EZ - 123 - 456
+*'''Date of Birth:'''
+**'''Age:''' {{age|2360|03|31}}
+*'''Sex:'''
+*'''Species:'''
+|-
+|style="background:teal; border-radius: 0 0 0 14px; border:0px solid #AFA3BF"|
+|style="background:teal" |
+!width=180 align=right|<font size="4" color=teal>MEDICAL RECORD</font>
+|-
+|style="background:teal; border-radius: 14px 0 0 0; border:0px solid #AFA3BF"|
+|colspan=2|
+*'''Height:''' 178 cm (5'10")
+*'''Weight:''' 73 kilos (160 lbs)
+*'''Blood Type:'''
+*'''[[T/E Rating]]:'''
+|-
+|style="background:teal;"|
+|colspan=2|
+===PAST MEDICAL HISTORY===
+*'''Chronic Illnesses:'''
+*'''Medications:'''
+*'''Allergies and Reactions:'''
+*'''Sexual/Reproductive History:'''
+|-
+|style="background:teal;"|
+|colspan=2|
+===PAST HOSPITALIZATIONS/SERIOUS ILLNESS===
+*'''SD 237005.05:'''
+*'''SD 237007.05:'''
+===PAST SURGICAL HISTORY===
+*'''SD 237005.05:'''
+*'''SD 237007.05:'''
+|-
+|style="background:teal;"|
+|colspan=2|
+===PSYCHIATRIC HISTORY===
+===SUBSTANCE USE HISTORY===
+*'''Alcohol:'''
+*'''Recreation Drugs:'''
+*'''Other:'''
+|-
+|style="background:teal;"|
+|colspan=2|
+===FAMILY MEDICAL HISTORY===
+*'''Mother:'''
+*'''Father:'''
+*'''Siblings:'''
+|-
+|style="background:teal;"|
+|colspan=2|
+===SOCIAL HISTORY===
+*'''Marital status:'''
+*'''Children:'''
+*'''Occupation/Assignment:'''
+*'''Diet:'''
+*'''Exercise:'''
+|-
+|style="background:teal;" colspan=3 height=4|
+|-
+|style="background:teal;"|
+|colspan=2|
+===PHYSICIANS' NOTES===
+*'''Medical Officer:'''
+*'''Medical Assessment:'''
+|-
+|style="background:teal;"|
+|colspan=2|
+===COUNSELORS' NOTES===
+*'''Counselor:'''
+*'''Psychological Assessment:'''
+|}
+__NOTOC__
+[[Category:Medical Records]]
 {{Gemini-crew}}
 [[Category:Alexander Richards|Medical Records]]

Alexander Richards/Medical Reports: Difference between revisions

Revision as of 01:28, 8 May 2014

LAST NAME, FIRST NAME MIDDLE NAME

PAST MEDICAL HISTORY

PAST HOSPITALIZATIONS/SERIOUS ILLNESS

PAST SURGICAL HISTORY

PSYCHIATRIC HISTORY

SUBSTANCE USE HISTORY

FAMILY MEDICAL HISTORY

SOCIAL HISTORY

PHYSICIANS' NOTES

COUNSELORS' NOTES

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