|PATIENT MEDICAL HISTORY|
|Name:||Age: 27 years||Sex: Male||Height: 69inch||Weight: 140lbs|
|[ ] Magical by nature/practices magic.||[ ] Can't have magic used on.||[ ] Contageous (see notes).|
|Average Lifespan: Immortal||Rate of Maturity: Very slow||Average age of Puberty: N/A|
Normal Diet: Blood
Common Ailments: None
Specific Notes: See my notes [Here]
|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: [ ] Average | [x] Low | [ ] High|
|Vision: [ ] Fine | [ ] Near Sighted | [ ] Far Sighted | [x] Enhanced|
| If Enhanced, further explain: Can see with details up to 1000yds if the air is clear, less if there is fog or smoke.
|Hearing: [ ] Deaf | [ ] Low | [ ] Average | [ ] High Range | [ ] Low Range | [x] Extremely Sensitive|
| If necessary, further explain:
|Smell: [ ] Cannot Smell | [ ] Low | [ ] Average | [ ] High | [x] Extremely Sensitive|
| If Extremely Sensitive, further explain: Capable of picking up the scent of blood from almost anywhere on the ship. Able to identify people and species by scent after initial exposure.
|Known Allergies: Deathly allergic to silver and sunlight, severely allergic to garlic.
Are there any potential complications with healing processes we should be aware of when treating you?: If injury level is extreme, the body may force its own survival by attacking those in the vicinity. Caution is recommended.
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?: Not at risk
Special notes on care: The only care required will be to replenish blood supply. Once that is done, the body will heal itself. Except in cases of silver, sunlight or garlic poisoning. In cases of silver exposure, every trace of the silver must be removed in order for healing to commence. In cases of sunlight, the wound will heal slowly (at approximately the rate of the average human) once removed from exposure. In cases of garlic, all traces of garlic must be cleaned away before the wound will heal. Species is highly susceptible to condition known as Black Death. Blood runs black, and there is no known cure at home world.
Record of Past Injuries: Far too many to be worth listing here, but none causing lasting damage due to high healing factor.
Ship Health Records: No outstanding issues.
|Date of Last Menses/Estrus/Equiv (skip if n/a):
Have you ever been sexually active?: Yes
Are you currently Sexually Active: No
Have you recently been screened for STIs?: Not susceptible
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: 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: