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Medical Information
Basic Info
Blood type
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O+
O-
A+
A-
B+
B-
AB+
AB-
Unknown
Allergies
Penicillin
Amoxicillin
Cephalosporins
Sulfa drugs (Sulfonamides)
NSAIDs (e.g., Ibuprofen)
Aspirin
Contrast dye (Iodine)
Latex
Peanuts
Tree nuts
Shellfish
Eggs
Milk / Dairy
Wheat / Gluten
Soy
Pollen
Dust mites
Pet dander
Mold
Insect stings
Other
Chronic Diseases
Diabetes (Type 1)
Diabetes (Type 2)
Hypertension
Coronary artery disease
Heart failure
Atrial fibrillation
Asthma
COPD
Epilepsy
Stroke / TIA
Chronic kidney disease
Liver disease
Thyroid disorder
Autoimmune disease
Rheumatoid arthritis
Osteoporosis
High cholesterol
Depression
Anxiety
Parkinson’s
Dementia
HIV
Cancer (history/active)
Bleeding disorder
Other
Temporary Conditions
Fracture
Sprain / Strain
Post-surgery recovery
Infection (recent)
Fever
Postpartum
Dehydration
Allergic reaction (recent)
Concussion
COVID-19 (recent)
Flu (recent)
Other
Medications
Medication Name
Dosage / Frequency
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Daily once
Daily twice
Daily thrice
Weekly once
Weekly twice
Weekly thrice
Monthly once
Monthly twice
As needed
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Surgeries / Operations
Surgery type
When
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Reproductive
Pregnancy
Yes
No
Trimester
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First (0–12 weeks)
Second (13–27 weeks)
Third (28–40+ weeks)
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Organ Donor
Donor
Yes
No
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