|PATIENT MEDICAL HISTORY|
|Name: Sandrilene fa Toren||Age: 17 years||Sex: Female||Height: 5'4"||Weight: 110 lbs|
|[X] Magical by nature/practices magic.||[ ] Can't have magic used on.||[ ] Contageous (see notes).|
|Average Lifespan: 80 years||Rate of Maturity: 18-25 years||Average age of Puberty: 12 years|
Normal Diet: Vegetables, meats, fruits, and grains. No alcohol.
Common Ailments: Colds, fevers, poxes
Specific Notes: Mage. Alcohol is known to cause a potentially disastrous flare of magic. Other drugs and medicines may have similar effects: prescribe with caution.
|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.|
|Vision: [X] Fine | [ ] Near Sighted | [ ] Far Sighted | [X] Enhanced||Blood Pressure: [X] Average | [ ] Low | [ ] High|
|If Enhanced, further explain: Sees magic. Vision is otherwise normal.|
|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: None |
Are there any potential complications with healing processes we should be aware of when treating you?: Possible interference of magic.
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: None
Record of Past Injuries: Mild stress and malnutrition for several weeks at the age of ten. Multiple cases of power exhaustion.
Ship Health Records:
|Date of Last Menses/Estrus/Equiv (skip if n/a): Approximately eight days past. |
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: None
|DRUGS AND MEDICATION|
|Are you or should you be on any prescribed medication? If so, list below: N/A|
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: Alcohol, once.
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
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