Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
|
Altura:
177 cm
(5'10") |
Peso:
76 kg
(168 lb) |
Cor dos olhos:
Castanho
|
Cabelo:
Ruivo/
Enrolado |
Tom de Pele:
Moreno
|
Ascendência:
Multi
|
|
Tipo Sanguíneo:
O+
|
Etnia:
German-Irish-Mexican/African American-Nat. American
|
||||
|
Escolaridade:
Pursuing AA/Collision Repair
|
Ocupação:
Lube Technician
|
||||
|
Interesses:
|
Baseball, Drawing, Motorcycles, Reading, Working out
|
||||
Medical
| Question | Response |
| Have you or any of your family members been diagnosed with alcoholism or drug addiction? If yes, relation and age affected: | No |
| Any dietary restrictions? If yes, explain: | No |
| Do you wear glasses or contact lenses? Are you near or far-sighted? | No |
| Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused: | Yes - Amoxicillin, hives and rash |
| CMV IgG Antibody | Negative |
| CMV IgM Antibody | Negative |
| Note any comments regarding above items: | N/A |
Family Medical HistoryVer lista de perguntas. here
Your Mother
| Question | Response |
| Current age or age at death | 47 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Problemas de Saúde
Saudável
Your Father
| Question | Response |
| Current age or age at death | 48 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Problemas de Saúde
Saudável
Your Mother's Father
| Question | Response |
| Current age or age at death | 79 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Problemas de Saúde
Saudável
Your Mother's Mother
| Question | Response |
| Current age or age at death | 63 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Lung Cancer (heavy smoker) |
Problemas de Saúde
Disease
Age Diagnosed
Treatment For Condition
Osteoarthritis
57
Medication
Your Mother's Sisters 1
| Question | Response |
| Current age or age at death | 54 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Problemas de Saúde
Saudável
Your Mother's Sisters 2
| Question | Response |
| Current age or age at death | 52 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Problemas de Saúde
Saudável
Your Mother's Sisters 3
| Question | Response |
| Current age or age at death | 40 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Problemas de Saúde
Saudável
Your Mother's Brothers 1
| Question | Response |
| Current age or age at death | 51 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Problemas de Saúde
Saudável
Your Father's Father
| Question | Response |
| Current age or age at death | 73 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Lung Cancer (smoker) |
Problemas de Saúde
Disease
Age Diagnosed
Treatment For Condition
Other
No other diagnosed health problems at time of death
Your Father's Mother
| Question | Response |
| Current age or age at death | 40 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Lung Cancer (heavy smoker) |
Problemas de Saúde
Disease
Age Diagnosed
Treatment For Condition
Other
No other diagnosed health problems at time of death
Religion:
| Faith | Christian |
| Denomination | Non-denominational |
Updates to Profile
| Update Available | N/A |
| Updates - Personal | N/A |
| Updates - Medical | N/A |
| Updates - Family Medical History | N/A |