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Jul 15, 2011 12:48



PATIENT MEDICAL HISTORY

Name:
Age: 27 years
Sex: Male
Height: 69inch
Weight: 140lbs

[ ] Magical by nature/practices magic.
[ ] Can't have magic used on.
[ ] Contageous (see notes).

VAMPIRE

Average Lifespan: Immortal
Rate of Maturity: Very slow
Average age of Puberty: N/A

Normal Diet: Blood

Common Ailments: None

Specific Notes: See my notes [Here]

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: [ ] Average | [x] Low | [ ] High

Vision: [ ] Fine | [ ] Near Sighted | [ ] Far Sighted | [x] Enhanced

If Enhanced, further explain: Can see with details up to 1000yds if the air is clear, less if there is fog or smoke.

Hearing: [ ] Deaf | [ ] Low | [ ] Average | [ ] High Range | [ ] Low Range | [x] Extremely Sensitive

If necessary, further explain:

Smell: [ ] Cannot Smell | [ ] Low | [ ] Average | [ ] High | [x] Extremely Sensitive

If Extremely Sensitive, further explain: Capable of picking up the scent of blood from almost anywhere on the ship. Able to identify people and species by scent after initial exposure.

Known Allergies: Deathly allergic to silver and sunlight, severely allergic to garlic.

Are there any potential complications with healing processes we should be aware of when treating you?: If injury level is extreme, the body may force its own survival by attacking those in the vicinity. Caution is recommended.

Do you have a healing factor different from the average for your species? If so, explain how here: No

Have you recently been screened for species, sex, and age specific cancer risks?: Not at risk

Special notes on care: The only care required will be to replenish blood supply. Once that is done, the body will heal itself. Except in cases of silver, sunlight or garlic poisoning. In cases of silver exposure, every trace of the silver must be removed in order for healing to commence. In cases of sunlight, the wound will heal slowly (at approximately the rate of the average human) once removed from exposure. In cases of garlic, all traces of garlic must be cleaned away before the wound will heal. Species is highly susceptible to condition known as Black Death. Blood runs black, and there is no known cure at home world.

Record of Past Injuries: Far too many to be worth listing here, but none causing lasting damage due to high healing factor.

Ship Health Records: No outstanding issues.

SEXUAL HEALTH

Date of Last Menses/Estrus/Equiv (skip if n/a):

Have you ever been sexually active?: Yes

Are you currently Sexually Active: No

Have you recently been screened for STIs?: Not susceptible

Species specific sexually related health notes and/or issues: None

DRUGS AND MEDICATION

Are you or should you be on any prescribed medication? If so, list below: No

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

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