Patient Medical History

[fireforger]

PATIENT MEDICAL HISTORY
Name: Daja Kisubo	Age: 19 years	Sex: Female	Height: 6 feet/183cm	Weight: 188lbs/85kg
[X] Magical by nature/practices magic.	[ ] Can't have magic used on.		[ ] Contageous (see notes).
HUMAN
Average Lifespan: 80 years	Rate of Maturity: 18 years		Average age of Puberty: 12 years
Normal Diet: Standard human dietary needs. Find full documentation [here]. Common Ailments: Colds, fevers, poxes. See file on [Common Human Illnesses]. Specific Notes: Mage. Magic may interact with magical healings; patient has been trained to keep her magic contained while being healed.
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 | [X] Enhanced
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:
Smell: [ ] Cannot Smell | [X] Low | [ ] 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?: 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?: No. Special notes on care: Alcohol is known to cause a potentially disastrous flare of magic. Other drugs and medicines may have similar effects: prescribe with caution. Record of Past Injuries: Multiple cases of prior power exhaustion. Dehydration at age of ten. Left palm contains a coating of 'living metal'. Appears to be a magical scar caused by a forest fore. Living metal does not appear to cause harm, but continues to grow causing the need for excess layers to be peeled off regularly. Ship Health Records: NA.
SEXUAL HEALTH
Date of Last Menses/Estrus/Equiv (skip if n/a): Three weeks prior. Have you ever been sexually active?: Yes. Are you currently Sexually Active: No Have you recently been screened for STIs?: No. Species specific sexually related health notes and/or issues: No known 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: 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: No.