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PATIENT MEDICAL HISTORY | ||||
Name: Sasami Masaki Jurai | Age: 8 years (+700) | Sex: Female | Height: 48 inch | Weight: 75 lbs |
[X] Magical by nature/practices magic. | [ ] Can't have magic used on. | [ ] Contagious (see notes). | ||
JURAIAN | ||||
Average Lifespan: ~10,000 Years (Earth-related) | Rate of Maturity: ~18-20 (educated) | Average age of Puberty: ~13-15 | ||
Normal Diet: List [Here] Common Ailments: List [Here] Specific Notes: Usage of healing magic "Curara" via connection to crewmate Aqua. Connection to deity-like being "Tsunami" (Effect unknown due to possibly on-ship effects) | ||||
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 | [ ] 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?: None 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: None Record of Past Injuries: Killed as a young child. Resurrected by deity "Tsunami" (OOC: This is what she believes, not what actually happened) Ship Health Records: Attacked by Mei-Xing while possessed. Assaulted by Ohm on Zokez II. Attacked by Alessa under virus influence. | ||||
SEXUAL HEALTH | ||||
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 | ||||
Reproductive Health (skip if N/A) | ||||
Date of Last Menses/Estrus/Equiv (skip if n/a): [insert date here] Number of pregnancies: 0 Number of pregnancies carried to term: 0 Age of first birth/hatching/etc. (if applicable): Total number of births/hatching/etc.: | ||||
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 |