[OOC/IC] -- Patient History Form.

Jul 15, 2011 09:39



PATIENT MEDICAL HISTORY

Name: Hikari Hoshi.
Age: 16 years
Sex: Female.
Height: 170 cm (5'7'')
Weight: 75 kg (165 pounds)

[X] Magical by nature/practices magic. Beyblader and Kamen Rider.
[ ] Can't have magic used on.
[ ] Contagious (see notes).

HUMAN

Average Lifespan: ~80-85 years
Rate of Maturity: Mentally around 23/24. Physically sixteen.
Average age of Puberty: 11.

Normal Diet: Standard human dietary needs. See full documentation [here]. Has a faster than normal metabolism and will need to consume more food to keep metabolic rate up.

Common Ailments: Colds, fevers, see file on [Common Human Illnesses]

Specific Notes: Patient has titanium plates, rods, and screws in right arm. Must be in warm environment to keep the limb from irritation. Currently has ~70% of original range of motion. Pain tolerance is very high.

Patient is also a Kamen Rider and claims that her powers grant her increased strength and acceleration.

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: N/A.

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

If necessary, further explain: N/A.

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

If Extremely Sensitive, further explain: N/A.

Known Allergies: No known allergies to medication, food, or fauna at this time.

Are there any potential complications with healing processes we should be aware of when treating you?: Rider powers may interfere only when patient strains self while using them. See patient supplied Rider powers [here].

Do you have a healing factor different from the average for your species? If so, explain how here: Not necessarily, Rider suit allows for extra durability.

Have you recently been screened for species, sex, and age specific cancer risks?: No.

Special notes on care: Needs to keep arm mobile and active, as well as be kept in a room temperature or higher environment to be able to fully use right arm.

Record of Past Injuries: Major fracture to arm, has sought out reconstructive surgery to repair the fracture. Severe scarring remains. All other scars have been acquired from earlier on in life.

Ship Health Records: Fractured wrist, mild burns and exhaustion.

SEXUAL HEALTH

Have you ever been sexually active?: No.

Are you currently Sexually Active: No.

Have you recently been screened for STIs?: No.

Species specific sexually related health notes and/or issues: Follows human sexual health standards. No known issues at present.

Reproductive Health (skip if N/A)

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

Number of pregnancies: 0.

Number of pregnancies carried to term: 0.

Age of first birth/hatching/etc. (if applicable): N/A.

Total number of births/hatching/etc.: 0.

DRUGS AND MEDICATION

Are you or should you be on any prescribed medication? If so, list below: Yes -- 400 mg of NSAIDs three times a day.

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:
N/A.

Do you currently take any recreational or non-prescribed drugs or substances? Is so, please list them and their frequency of use below:
N/A.

!patient history

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