| 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. |
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| 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. |
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| Blood Pressure: [X] Average | [ ] Low | [ ] High | ||||
| Vision: [ ] Fine | [X] Near Sighted | [ ] Far Sighted | [ ] Enhanced | ||||
| If Enhanced, further explain: |
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| Hearing: [ ] Deaf | [ ] Low | [ ] Average | [X] High Range | [ ] Low Range | [ ] Extremely Sensitive | ||||
| If necessary, further explain: |
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| Smell: [ ] Cannot Smell | [ ] Low | [X] Average | [ ] High | [ ] Extremely Sensitive | ||||
| If Extremely Sensitive, further explain: |
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| 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: |
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| 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: . |
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| 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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