Rebecca Hollendale/Medical Record

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Rebecca Hollendale

MEDICAL RECORD
  • Height: 5'10
  • Weight: 130
  • Blood Type: O+
  • T/E Rating: T0/E0

PAST MEDICAL HISTORY

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

PAST HOSPITALIZATIONS/SERIOUS ILLNESS

PAST SURGICAL HISTORY

PSYCHIATRIC HISTORY

SUBSTANCE USE HISTORY

  • Alcohol: Recovering alcoholic
  • Recreation Drugs: None
  • Other: None

FAMILY MEDICAL HISTORY

  • Mother: None
  • Father: None
  • Siblings: None

SOCIAL HISTORY

  • Marital status:
  • Children: 1 son
  • Occupation/Assignment: Martial Arts Instructor
  • Diet: Omnivore
  • Exercise: 5-7 times per week

PHYSICIANS' NOTES

COUNSELORS' NOTES