Patient forms
Attention, members of the Gotei 13. Below is the following form needed before posting within the infirmary. Please fill this out, and post in the infirmary thread after. A member of the 4th will be able to provide help. Please follow all rules while posting.
Name:
Blood type:
cause of injuries:
List of injuries:
Name: Takasugi Tsukasa Masao
Blood type: O+
Cause of injuries: As part of an experiment to see if it would be possible to quickly replace KIA Captains with fresh Academy students, Takasugi was injected with a solution by the 12th Division. More information here, in the biography. The chemical make-up of the solution injected into Takasugi is unknown - the 12th Division declined to elaborate on its contents.
List of injuries: Persistent dizziness, unstable reiatsu outbursts, vomiting.
Name: Kisaragi Madara
Blood type: 0 +
Cause of injuries: Madara was getting ready to take a walk and on his way out, he awkwardly stepped on his left foot which might have caused a sprain.
List of injuries: Pain when the left foot is bearing weight, tenderness and swelling around the ankle, restricted range of motion.