[IG: Medical History]

Jan 24, 2007 18:16


Tabula Rasa Medical History

Name: Lionel Thayer
Gender: Male
Age, or approximate age of human body: 25
Length of time on island (in months): 14 months
Date and Place of Origin: May 1977, California, USA, Earth
Were you human before coming to TR: Yes

Living Situation

Where on the island do you live? Compound, ground floor, male dorm #27
Number of roommates: 1, Matt Farrell
Do you live with children under the age of 18: No

General Health

Do you consider yourself healthy now: Yes
What, if any, medications did you take regularly before coming to Tabula Rasa: Took different pain meds for months while recovering from a car crash
Are you allergic to any medications: None
Have you experienced any new health problems since arriving? If so, please describe: None
When was your last tetanus shot? Age 9
Were you vaccinated for smallpox as a child? (If you were, you should have a small, round scar on your upper arm.) No
What is your blood type, if known: O

Have you had any of the following:
Chicken pox

If you contracted other diseases before arriving, that are not on this list, please list them, and their symptoms: N/A
To the best of your knowledge, have you ever been exposed to any of the following:
None
Are there other health conditions that you want the clinic staff to know about? None

For Those Who Can Bear Children N/A

Are you currently pregnant (if so, when are you due):
Date of your last menstrual period if known:
List any previous -pregnancies, and the approximate date(s):
Do you have children, either on the island or not, if so, list their ages:
Have you miscarried, aborted a pregnancy, or had a still birth? If so, list date(s):
What birth control methods have you used in the past, and currently:

Family History

Do you have any blood relatives here, if yes, list names: None

Do any of the following run in your immediate family (mother, father, sisters, brothers): None aware of

Lifestyle

Do you smoke: No
Tobacco, or marijuana: N/A
If yes, how often: N/A

Do you drink alcohol? Yes
If yes, how much: Drink socially

Do you drink caffinated beverages such as coffee or tea? Yes
If yes, how much: Cup or two of coffee or tea a day

Mental Health (If you answer yes to any of these, please list symptoms, dates and treatments.)

Have you experienced a serious head injury, either on the island or before: Yes, during car accident one year prior to arrival on the island
Have you been treated for depression with medication or herbs: No treatment.
Have you experienced manic episodes: None
Have you had unexplained mood swings: Yes
Have you been diagnosed with serious mental illness, such as schizophrenia, multiple personality disorder, obsessive-compulsive disorder, or psychosis: None

in-game, medical history

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