Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
|
Height:
187 cm
(6'2") |
Weight:
90 kg
(199 lb) |
Eye Color:
Brown
|
Hair:
Black/
Straight |
Skin Tone:
Medium Dark
|
Ancestry:
Asian
|
|
Blood Type:
A+
|
Ethnic Background:
Sri Lankan/Sri Lankan
|
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|
Education:
BA/Management and Marketing
|
Occupation:
Business Owner
|
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|
Interests:
|
Fishing, Hunting, Reading
|
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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: | No |
| CMV IgG Antibody | Negative |
| CMV IgM Antibody | Negative |
| Note any comments regarding above items: | N/A |
Family Medical HistorySee list of questions asked here
Your Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 65 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 68 | |
| Health Problem | Diabetes, treated with medication and diet | 44 |
| Living / Dead | Living |
Brothers
Your Brother 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 38 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Sisters
Your Sister 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 30 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Daughters
Your Daughter 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 1 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 85 | |
| Health Problem | Heart failure | 85 |
| Cause of death: Heart failure | 85 | |
| Living / Dead | Dead |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 88 | |
| Health Problem | Heart failure | 88 |
| Cause of death: Heart failure | 88 | |
| Living / Dead | Dead |
Your Mother's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 75 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 62 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 74 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 72 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 90 | |
| Health Problem | Diabetes, treatment unknown | 50 |
| Cause of death: Heart failure | 90 | |
| Living / Dead | Dead |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 78 | |
| Health Problem | Heart failure | 78 |
| Cause of death: Heart failure | 78 | |
| Living / Dead | Dead |
Your Father's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 75 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 82 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Religion:
| Faith | Other |
| Denomination | Buddhist |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to donor Personal Profile: March 2013. |
| Updates - Medical | No change to donor Medical Profile: March 2013. |
| Updates - Family Medical History | No change to donor Family Medical History: March 2013. |