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Jul 15, 2011 17:57



PATIENT MEDICAL HISTORY

Name: Jamie Hemeros
Age: approx. 18 yr
Sex: M
Height: 65 in
Weight: 125 lbs

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

Human (Homo sapiens sapiens)

Average Lifespan: ~80 yrs.
Rate of Maturity: 18-22 yrs.
Average age of Puberty: ~11-14 yrs.

Normal Diet: Mess hall slop, meats, fruits, vegetables, grains, etc.

Common Ailments: See file on [Common human ailments]

Specific Notes: (healing factors, special needs, etc)
N/A

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: None

Are there any potential complications with healing processes we should be aware of when treating you?: No

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?: No

Special notes on care: (Such as contagious diseases/conditions, special means of handling, special care taken in handling) N/A

Record of Past Injuries: Broken right arm, age 15, healed magically.

Ship Health Records: Infected by rage virus. Affected by Melting Clock; deaged to approx. 5 years of age before reversed.

SEXUAL HEALTH

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

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: N/A

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: Consumes alcohol infrequently; used tobacco during a mission.

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

*It might be noted that Jamie freezes up and looks unsure of how to answer this question before responding. If pressed about it, he gets defensive and a little snappish and says he wasn't expecting to be quizzed on his sexual history.

ic info

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