} Initial Physical
PATIENT MEDICAL HISTORY
Name: Sumeragi Lee Noriega
Age: 31 years
Sex: F
Height: 5'4"/ 163 cm
Weight: 157 lbs/ 71 kg
[ ] Magical by nature/practices magic.
[ ] Can't have magic used on.
[ ] Contagious (see notes).
Human
Average Lifespan: 90-95 years
Rate of Maturity: ~18 years
Average age of Puberty: Onset at 12 years
Normal Diet: Standard human dietary needs. Find full documentation [here].
Common Ailments: Colds, fevers, poxes. See file on [Common Human Illnesses].
Specific Notes: None
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: Mild hayfever, mild contact allergy to nickel
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?: Yes
Special notes on care: Patient has spent long periods of time in low-gravity environment, and displays minor weightlessness-related bone mass loss. Some evidence of cirrhosis, likely due to long-term alcohol use. Recommend additional screening before prescription of hepatotoxic drugs.
Record of Past Injuries: Broken ankle at age 13, no lasting effects. No other serious injuries or illnesses
Ship Health Records: N/A
SEXUAL HEALTH
Have you ever been sexually active?: Yes
Are you currently Sexually Active: No; likely to be in the near future
Have you recently been screened for STIs?: Yes
Species specific sexually related health notes and/or issues: None
Reproductive Health (skip if N/A)
Date of Last Menses/Estrus/Equiv: 6 mo. previous to arrival (hormonal contraceptives)
Number of pregnancies: 0
Number of pregnancies carried to term: 0
Age of first birth/hatching/etc. (if applicable): 0
Total number of births/hatching/etc.: 0
DRUGS AND MEDICATION
Are you or should you be on any prescribed medication? If so, list below:
Hormonal contraceptives
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:
Occasional marijuana use during college, none in the past ten years. One prior use of LSD. Drinks alcohol regularly
Do you currently take any recreational or non-prescribed drugs or substances? Is so, please list them and their frequency of use below:
Moderate alcohol consumption, 4-5 times a week