(no subject)

Jul 15, 2011 09:05



PATIENT MEDICAL HISTORY

Name: Billy Cranston
Age: approx. 18 years
Sex: Male
Height: 67 inch/ 170 cm
Weight: 160 lbs/73 kg

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

HUMAN

Average Lifespan: 73 yrs
Rate of Maturity: approx 18 yrs
Average age of Puberty: 12 yrs

Normal Diet: Human diet: meats, vegetables, grains

Common Ailments: Human ailments: colds, viruses, etc...

Specific Notes: Is a Power Ranger. When powers are active or just deactivated, adrenaline levels elevated.

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: [ ] Fine | [X] Near Sighted | [ ] Far Sighted | [ ] Enhanced

If Enhanced, further explain:

Hearing: [ ] Deaf | [ ] Low | [ ] Average | [X] 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?: Power Ranger powers, while they haven't interfered before, may react badly to something encountered. [description of how they work]

Do you have a healing factor different from the average for your species? If so, explain how here: Slightly accelerated, about 33% faster, when powers are active

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

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

Record of Past Injuries: Broken arm, torn leg, various tears, mostly healed with magic.

Ship Health Records:

SEXUAL HEALTH

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

Have you ever been sexually active?: Yes

Are you currently Sexually Active: Yes

Have you recently been screened for STIs?: No

Species specific sexually related health notes and/or issues: .

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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