(Trans 9) IC: Medical form
PATIENT MEDICAL HISTORY
Name: Jamie McCrimmon
Age: Approximately 21 years
Sex: Male
Height: 68"/172.72 cm
Weight: 143 lbs/64.86kg
[ ] Magical by nature/practices magic.
[ ] Can't have magic used on.
[ ] Contagious (see notes).
Human
Average Lifespan: (number provided is appropriate for average based on someone born in the year 1729)
Rate of Maturity: 16-18
Average age of Puberty: 12
Normal Diet: Human diet: fruits, vegetables, meats, grains, and the like.
Common Ailments: Colds, flus, normal human illnesses
Specific Notes: (healing factors, special needs, etc)
Power Ranger. [For detailed file, reference crew member Billy Cranston]
GENERAL HEALTH
All of the following sense-related questions are to be answered in comparison to an average Homo sapiens. Ask your medical provider for assistance in answering this section.
Blood Pressure: [X] Average | [ ] Low | [ ] High
Vision: [X] Fine | [ ] Near Sighted | [ ] Far Sighted | [ ] Enhanced
If Enhanced, further explain:
Hearing: [ ] Deaf | [ ] Low | [X] Average | [ ] High Range | [ ] Low Range | [ ] Extremely Sensitive
If necessary, further explain:
Smell: [ ] Cannot Smell | [ ] Low | [X] Average | [ ] High | [ ] Extremely Sensitive
If Extremely Sensitive, further explain:
Known Allergies:
Sensitivity to toxic gases, causes sneezing.
Are there any potential complications with healing processes we should be aware of when treating you?:
Not sure if the Ranger powers would affect anything. [For detailed file, reference crew member Billy Cranston]
Do you have a healing factor different from the average for your species? If so, explain how here: Slightly faster healing when Ranger powers are active.
Have you recently been screened for species, sex, and age specific cancer risks?: No.
Special notes on care: (Such as contagious diseases/conditions, special means of handling, special care taken in handling)
Record of Past Injuries: Temporary paralysis, gunshot wound, occasional unconsciousness due to a few wee things. (List of occasions Jamie can actually remember follow here.)
Ship Health Records: Mild concussion, bruised leg, smoke inhalation, sprained shoulder, various cuts and bruises.
SEXUAL HEALTH
Have you ever been sexually active?: Yes.
Are you currently Sexually Active: No.
Have you recently been screened for STIs?: No.
Species specific sexually related health notes and/or issues:
DRUGS AND MEDICATION
Are you or should you be on any prescribed medication? If so, list below:
n/a
Have you taken any recreational or non-prescribed drugs or substances in the past? Is so, please list them and their frequency of use below:
No.
Do you currently take any recreational or non-prescribed drugs or substances? Is so, please list them and their frequency of use below: No.