Questions
Personal Information
Talents:
| Voice: | Tenor |
| Instrument: Years of experience: | None |
| Other talents: Years of experience | None |
Favorite:
| Color | Black |
| Food | Indian |
| Music | Bollywood |
| Animal | Dog |
| Pet | Dog |
| Car | Sport |
| Movie | Titanic |
| Song | "Once Upon a Time" |
| Play | Beauty and the Beast |
Goals:
| Academic | None |
| Professional | Project manager |
| Personal | Financially rich |
Religion:
| Faith | Other |
| Denomination | Hindu |
Languages:
| Speak | English, Hindi, Gujarati |
| Read | English, Hindi, Gujarati, Sanskrit |
| Write | English, Hindi, Gujarati, Sanskrit |
Sports:
| Play | Cricket, Tennis, Badminton |
| Watch | Cricket, Tennis, Badminton |
Siblings:
| # Brothers | 1 |
| # Sisters | 1 |
| Are you a twin? Identical or fraternal? | No |
| # of twins in your family | N/A |
| # Identical sets | 0 |
| # Fraternal sets | 0 |
Academics
Standard Test Score: provide score or denote N/A if not taken
| SAT on scale of | N/A |
| ACT on scale of | N/A |
| GRE on scale of | 1300 - out of 2000 |
| MCAT on scale of | N/A |
| LSAT on scale of | N/A |
| GMAT on scale of | N/A |
| TOEFL on scale of | 72 - out of 120 |
| Other on scale of | N/A |
High School
| Question | Response | on scale of |
| GPA on scale of | 4.0 | 4.0 |
College
| Question | Response | on scale of |
| GPA on scale of | 3.80 | 4.0 |
Graduate School
| Question | Response | on scale of |
| GPA on scale of | 3.60 | 4.0 |
Subjects Studied:
| Major subjects | Pharmacology |
| Minor subjects | N/A |
Degrees
| Bachelor's | BPharm/Pharmaceutical Sciences |
| Master's | MS/Pharmaceutical Manufacturing |
| Doctorate | N/A |
| Other(s) | N/A |
Awards & Activities
| High school | Classroom and extra-curricular activities monitor |
| College | N/A |
| Academic | N/A |
| Professional | N/A |
| Political | N/A |
| Personal | Gardening, Time with friends |
| Charitable | Volunteer work for food bank, Fundraising for March of Dimes |
| Others | N/A |
Military
| Served in military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | 0 |
Physical Features
| Hands | Left-Handed |
| Fingers | Medium |
Sizes & Measurements
| Neck (inches) | 14 |
| Chest (inches) | 36 |
| Inseam (inches) | 31 |
| Waist (inches) | 34 |
| Sleeve (inches) | 32 |
| Wrist (inches) | 7 |
| Hat size | 7 |
| Shoe size | 9.5 |
Physical Aids
Eyes:
| Vision | Normal - (Near-sighted before laser surgery) |
| Glasses | None - (Single glasses before laser surgery) |
| Astigmatism | No |
| Age started wearing glasses/contacts | 13 |
| Laser surgery? | Yes |
Dental:
| Device | None |
| Reason | N/A |
| Age range during use | N/A |
Other Physical Aids:
| List | None |
| Reason/cause | N/A |
Facial Features
Eyes:
| Set |
|
| Size |
|
| Shape |
|
| Color |
|
| Shade |
|
Narrow
Average
Wide
Small
Average
Large
Almond
Oval
RoundEyebrows:
| Arch |
|
| Thickness |
|
| Set |
|
Thin
Average
ThickNose:
| Size |
|
| Shape |
|
| Width |
|
| Length |
|
| Bridge |
|
| Nostril flare |
|
| Septum |
|
Round
Straight
Wide
Convex
Straight
ConcaveCheekbones:
| Set |
|
| Prominence |
|
Mouth:
| Size |
|
| Lips |
|
| Turn |
|
Small
Average
Large
Thin
Average
FullTeeth:
| Size |
|
| Set |
|
| Condition |
|
Average
Large
SmallChin:
| Shape |
|
| Prominence |
|
| Cleft |
|
Round
Oval
Square
None
Slight
StrongEars:
| Size |
|
| Set |
|
| Angle |
|
| Lobe size |
|
| Lobe attachment |
|
Small
Average
Large
Flat
Average
Acute
Detached
AttachedHair:
| Color at birth |
|
| Natural color in adulthood |
|
| Shade |
|
| Type |
|
| Fullness |
|
| Texture |
|
Skin:
| Tone |
|
| Tan ability |
|
| Condition |
|
Hairline:
| Forehead |
|
| Contour |
|
Other Facial Features:
| Moles |
|
| Freckles |
|
| Dimples |
|
| Adam's apple |
|
Facial Hair
| Thickness |
|
| Shade |
|
Family Information
Donor's Parents
Donor's Father Personal Information
| Occupation | Merchant |
Donor's Father Education:
| Level | High school |
| Degree | Not Completed |
| Subject | General Studies |
Donor's Father Religion:
| Faith | Other |
| Denomination | Hindu |
| Primary ethnic origins: | Indian |
Donor's Father Languages:
| Speak | Gujarati |
| Read | Gujarati |
| Write | Gujarati |
Donor's Father Talents:
| Voice | Tenor |
| Instrument yrs experience | None |
| Other yrs experience | None |
Donor's Father Physical Information
Body
| Age | 58 - (deceased) |
| Height | 5'9" |
| Weight | 185 lbs. |
| Hands | Right-Handed |
Donor's Father Facial Features
Eyes:
| Eye Color | Hazel |
| Eye shade | Light |
| Vision | Near-Sighted |
| Glasses | Single |
| Astigmatism | No |
| Age started wearing glasses/contacts yrs | 52 |
Hair:
| Original hair color | Black |
| If gray, age turned gray | 50 |
| Type | Straight |
Skin:
| Skin Tone | Dark |
| Skin Condition | Combination |
Other:
| Chin cleft | None |
| Ear lobe | Detached |
| Facial Dimples | None |
Military
| Served in Military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | 0 |
Donor's Mother Personal Information
| Occupation | Homemaker |
Donor's Mother Education:
| Level | Grade school |
| Degree | Not Completed |
| Subject | General Studies |
Donor's Mother Religion:
| Faith | Other |
| Denomination | Hindu |
| Primary ethnic origins: | Indian |
Donor's Mother Languages:
| Speak | Gujarati |
| Read | Gujarati |
| Write | Gujarati |
Donor's Mother Talents:
| Voice | Alto |
| Instrument yrs experience | None |
| Other yrs experience | None |
Donor's Mother Physical Information
Body
| Age | 59 |
| Height | 5'2" |
| Weight | 170 lbs. |
| Hands | Right-Handed |
Facial Features
Eyes:
| Eye Color | Hazel |
| Eye shade | Dark |
| Vision | Near-Sighted |
| Glasses | Single |
| Astigmatism | No |
| Age started wearing glasses/contacts yrs | 45 |
Hair:
| Original hair color | Black |
| If gray, age turned gray | 40 |
| Type | Straight |
Skin:
| Skin Tone | Light |
| Skin Condition | Combination |
Other:
| Chin cleft | None |
| Ear lobe | Attached |
| Facial Dimples | None |
Military
| Served in Military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | 0 |
Donor's Siblings
Donor's Sibling(s) (1-4)
Donor's Sibling #1
| Full/Half sibling | Full |
Sibling #1 Physical Information
Body
| Sex | Male |
| Age | 35 |
| Height | 5'7" |
| Weight | 150 lbs. |
| Hands | Right-Handed |
Sibling #1 Personal Information
| Occupation | Merchant |
Education:
| Level | High school |
| Degree | Not Completed |
| Subject | General Studies |
Religion:
| Faith | Other |
| Denomination | Hindu |
Languages:
| Speak | Gujarati, English, Hindi |
| Read | Gujarati, English, Hindi |
| Write | Gujarati, English, Hindi |
Talents:
| Voice | Tenor |
| Instrument Years of experience | None |
| Other Years of experience | None |
Sibling #1 Children:
| # Boys Ages: | 1 - 11 |
| # Girls Ages: | 1 - 13 |
Sibling #1 Facial Features
Eyes:
| Eye color | Hazel |
| Eye shade | Medium |
| Vision | Normal |
| Glasses | None |
| Astigmatism | No |
| Age started wearing glasses/contacts | 0 |
Hair:
| Original hair color | Black |
| If gray, age turned gray | N/A |
| Type | Straight |
Skin:
| Skin tone | Light |
| Skin condition | Combination |
Other:
| Chin cleft | None |
| Ear lobe | Attached |
| Facial dimples | Slight |
Military
| Served in military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | 0 |
Donor's Sibling #2
| Full/Half sibling | Full |
Sibling #2 Physical Information
Body
| Sex | Female |
| Age | 33 |
| Height | 5'2" |
| Weight | 160 lbs. |
| Hands | Right-Handed |
Sibling #2 Personal Information
| Occupation | Homemaker |
Education:
| Level | High school |
| Degree | Diploma |
| Subject | General Studies |
Religion:
| Faith | Other |
| Denomination | Hindu |
Languages:
| Speak | Gujarati, English, Hindi |
| Read | Gujarati, English, Hindi |
| Write | Gujarati, English, Hindi |
Talents:
| Voice | Soprano |
| Instrument Years of experience | None |
| Other Years of experience | None |
Sibling #2 Children:
| # Boys Ages: | 0 |
| # Girls Ages: | 2 - 13, 8 |
Sibling #2 Facial Features
Eyes:
| Eye color | Hazel |
| Eye shade | Medium |
| Vision | Normal |
| Glasses | None |
| Astigmatism | No |
| Age started wearing glasses/contacts | 0 |
Hair:
| Original hair color | Black |
| If gray, age turned gray | N/A |
| Type | Straight |
Skin:
| Skin tone | MedDk |
| Skin condition | Combination |
Other:
| Chin cleft | None |
| Ear lobe | Attached |
| Facial dimples | None |
Military
| Served in military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | 0 |
Father's Siblings
Father's Brothers
| # of Brothers | 2 |
| Ages of Brothers: | 57, 55 |
| Education levels for each: | Grade school, Grade school |
| Occupations for each: | Merchant, Merchant |
| Religions for each: | Hindu, Hindu |
Father's Brothers' Total Children:
| # Boys | 4 |
| # Girls | 1 |
Father's Sisters
| # of Sisters | 1 |
| Ages of Sisters: | 58 |
| Education levels for each: | Grade school |
| Occupations for each: | Homemaker |
| Religions for each: | Hindu |
Father's Sisters' Total Children:
| # Boys | 2 |
| # Girls | 1 |
Mother's Siblings
Mother's Brothers
| # Brothers | 4 |
| Ages of Brothers: | 70, 65, 60, 55 |
| Education levels for each: | No formal education (all) |
| Occupations for each: | Farmer (all) |
| Religions for each: | Hindu (all) |
Mother's Brothers' Total Children:
| # Boys | 7 |
| # Girls | 5 |
Mother's Sisters
| # Sisters | 3 |
| Ages of Sisters: | 72, 68, 63 |
| Education levels for each: | No formal education (all) |
| Occupations for each: | Homemaker (all) |
| Religions for each: | Hindu (all) |
Mother's Sisters' Total Children:
| # Boys | 6 |
| # Girls | 3 |
Father's Parents
Father's Father
Education
| Level | No formal education |
| Degree | None |
| Subject | N/A |
| Occupation: | Farmer |
| Primary ethnic origins: | Indian |
Siblings:
| # Brothers | 2 |
| # Sisters | 2 |
Other:
| Languages | Gujarati |
| Religion | Hindu |
Military
| Branch | N/A |
| Rank | N/A |
| Service Yrs | 0 |
Father's Mother
Education
| Level | No formal education |
| Degree | None |
| Subject | N/A |
| Occupation: | Homemaker |
| Primary ethnic origins: | Indian |
Siblings:
| # Brothers | 4 |
| # Sisters | 1 |
Other:
| Languages | Gujarati |
| Religion | Hindu |
Military
| Branch | N/A |
| Rank | N/A |
| Service Yrs | 0 |
Mother's Parents
Mother's Father
Education
| Level | No formal education |
| Degree | None |
| Subject | N/A |
| Occupation: | Farmer |
| Primary ethnic origins: | Indian |
Siblings:
| # Brothers | 2 |
| # Sisters | 2 |
Other:
| Languages | Gujarati |
| Religion | Hindu |
Military
| Branch | N/A |
| Rank | N/A |
| Service Yrs | 0 |
Mother's Mother
Education
| Level | No formal education |
| Degree | None |
| Subject | N/A |
| Occupation: | Homemaker |
| Primary ethnic origins: | Indian |
Siblings:
| # Brothers | 2 |
| # Sisters | 2 |
Other:
| Languages | Gujarati |
| Religion | Hindu |
Military
| Branch | N/A |
| Rank | N/A |
| Service Yrs | 0 |