Questions
Personal Information
Talents:
| Voice: | Tenor |
| Tell us about your interests/talents and how long you have been pursuing. Provide several. | I like exploring the world. I have always been curious about biological laws. |
Favorite:
| Color | Blue |
| Food | Vegetarian |
| Music | Jazz |
| Animal | Fish |
| Pet | N/A |
| Car | BMW |
| Movie | Action movies, Rom-Com |
| Song | Ed Sheeran, Adele, Freddie Mercury, The Beatles |
Goals:
| Academic | Professor |
| Professional | Neurosurgeon |
| Personal | A happy father of three kids. |
Religion:
| Faith | Hindu |
| Denomination | N/A |
Languages:
| Speak | Nepali, Hindi, English, Spanish |
Sports:
| Play | Cricket, Football, Chess |
| Watch | Everything except Golf and Polo |
Siblings:
| Are you or any of your siblings twins? Please specify who and if they are fraternal or identical | No |
Academics
Standard Test Score: provide score or denote N/A if not taken
| SAT on scale of | N/A - N/A |
| ACT on scale of | N/A - N/A |
| GRE on scale of | N/A - N/A |
| MCAT on scale of | N/A - N/A |
| LSAT on scale of | N/A - N/A |
| GMAT on scale of | N/A - N/A |
| TOEFL on scale of | N/A - N/A |
| Other on scale of | USMLE STEP 1 250 - 280 |
High School
| Question | Response | on scale of |
| GPA on scale of | 83.2 | 100 |
College
| Question | Response | on scale of |
| GPA on scale of | 70 | 100 |
Graduate School
| Question | Response | on scale of |
| GPA on scale of | N/A | 0 |
Subjects Studied:
| Major subjects | Internal Medicine and General Surgery |
| Minor subjects | N/A |
Degrees
| Bachelor's | MBBS (in Nepal) |
| Master's | N/A |
| Doctorate | N/A |
| Other(s) | N/A |
Awards & Activities
| High school | Cricket |
| College | Pre-medicine studies |
| Academic | N/A |
| Professional | N/A |
| Political | N/A |
| Personal | Exploring the World |
| Charitable | N/A |
| Others | Chess |
Military
| Served in military | No |
| Branch | N/A |
| Rank | N/A |
| Years of service | N/A |
Physical Features
| Hands | Ambidextrous |
| Fingers | Medium |
Sizes & Measurements
| Neck (inches) | 16 |
| Chest (inches) | 45 |
| Inseam (inches) | 34 |
| Waist (inches) | 32 |
| Sleeve (inches) | 28 |
| Hat size | 6 ¾ |
| Shoe size | 8 |
Physical Aids
Eyes:
| Vision | Far-Sighted |
| Glasses | Single - -1.75 |
| Astigmatism | No |
| Age started wearing glasses/contacts | 19 |
| Laser surgery? | No |
Dental:
| Device | None |
| Reason | N/A |
| Age range during use | N/A |
Other Physical Aids:
| List | N/A |
| 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 |
|
Round
Straight
Wide
Convex
Straight
ConcaveCheekbones:
| Set |
|
Mouth:
| Size |
|
| Lips |
|
| Turn |
|
Small
Average
Large
Thin
Average
FullTeeth:
| Size |
|
| Set |
|
| Gap | No |
| Condition |
|
Average
Large
SmallChin:
| Shape |
|
| Prominence |
|
| Cleft |
|
Round
Oval
Square
None
Slight
StrongEars:
| Size |
|
| Set |
|
| Angle |
|
| Lobe size |
|
| Lobe attachment |
|
Small
Average
Large
Detached
AttachedHair:
| Color at birth |
|
| Natural color in adulthood |
|
| Shade |
|
| Type |
|
| Fullness |
|
| Texture |
|
Skin:
| Tone More about skin tones |
|
| Tan ability |
|
| Condition |
|
Hairline:
| Forehead |
|
| Contour |
|
Other Facial Features:
| Moles |
|
| Freckles |
|
| Dimples |
|
| Adam's apple |
|
Facial Hair
| Thickness |
|
| Color |
|
| Shade |
|
Family Information
Donor's Parents
Donor's Father Personal Information
| Occupation | Consultant |
Donor's Father Education:
| Level | Graduate school |
| Degree | Master |
| Subject | Sociology, Rural Development |
Donor's Father Religion:
| Faith | Hindu |
| Denomination | N/A |
Donor's Father Languages:
| Speak | Nepali, Hindi, English |
Donor's Father Talents:
| Voice | Tenor |
| Instrument | N/A |
| Other | N/A |
Donor's Father Physical Information
Body
| Age | 53 |
| Height | 5' 7" |
| Weight | 154 lbs. |
| Hands | Right-Handed |
Donor's Father Facial Features
Eyes:
| Eye Color | Brown |
| Eye shade | Medium |
| Corrective Lenses | No |
Hair:
| Original hair color | Black |
| Type | Straight |
Skin:
| Skin Tone More about skin tones | Limestone |
Other:
| Chin cleft | Medium |
| Ear lobe | Attached |
| Facial Dimples | None |
Donor's Mother Personal Information
| Occupation | Teacher |
Donor's Mother Education:
| Level | Graduate school |
| Degree | Master |
| Subject | Curriculum Management and Education |
Donor's Mother Religion:
| Faith | Hindu |
| Denomination | N/A |
Donor's Mother Languages:
| Speak | Nepali, Hindi, English |
Donor's Mother Talents:
| Voice | Soprano |
| Instrument | N/A |
| Other | N/A |
Donor's Mother Physical Information
Body
| Age | 46 |
| Height | 5' 1" |
| Weight | 132 lbs. |
| Hands | Right-Handed |
Facial Features
Eyes:
| Eye Color | Brown |
| Eye shade | Medium |
| Corrective Lenses | No |
Hair:
| Original hair color | Black |
| Type | Straight |
Skin:
| Skin Tone More about skin tones | Honey |
Other:
| Chin cleft | Slight |
| Ear lobe | Attached |
| Facial Dimples | None |
Donor's Siblings
Donor's Sibling(s) (1-4)
Donor's Sibling #1
| Full/Half sibling | Full |
Sibling #1 Physical Information
Body
| Age | 23 |
| Height | 5' 1" |
| Weight | 110 lbs. |
| Hands | Right-Handed |
Sibling #1 Personal Information
| Occupation | Physician |
Education:
| Level | College |
| Degree | Bachelor |
| Subject | MBBS |
Languages:
| Speak | English, Nepali, Hindi |
Talents:
| Voice | Soprano |
| Instrument | N/A |
| Other | N/A |
Sibling #1 Children:
| # Boys Ages: | 0 |
| # Girls Ages: | 0 |
Sibling #1 Facial Features
Eyes:
| Eye color | Brown |
| Eye shade | Dark |
| Corrective Lenses | No |
Hair:
| Original hair color | Black |
| Type | Straight |
Skin:
| Skin tone More about skin tones | Chestnut |
Other:
| Chin cleft | Medium |
| Ear lobe | Detached |
| Facial dimples | None |
Father's Siblings
Father's Brothers
| # of Brothers | 1 |
| Ages of Brothers: | 56 |
| Education levels for each: | High School |
| Occupations for each: | Teacher |
Father's Brothers' Total Children:
| # Boys | 2 |
| # Girls | 4 |
Father's Sisters
| # of Sisters | 2 |
| Ages of Sisters: | 60, 57 |
| Education levels for each: | Grade School, Grade School |
| Occupations for each: | Homemaker, Homemaker |
Father's Sisters' Total Children:
| # Boys | 6 |
| # Girls | 4 |
Mother's Siblings
Mother's Brothers
| # Brothers | 2 |
| Ages of Brothers: | 50, 43 |
| Education levels for each: | Some College, Some College |
| Occupations for each: | Business, Homemaker |
Mother's Brothers' Total Children:
| # Boys | 1 |
| # Girls | 3 |
Mother's Sisters
| # Sisters | 3 |
| Ages of Sisters: | 51, 48, 38 |
| Education levels for each: | Grade School, Grade School, Graduate School |
| Occupations for each: | Homemaker, Business, Banker |
Mother's Sisters' Total Children:
| # Boys | 4 |
| # Girls | 2 |
Father's Parents
Father's Father
Education
| Level | Some college |
| Degree | Not Completed |
| Occupation: | Priest |
Siblings:
| # Brothers | 4 |
| # Sisters | 2 |
Other:
| Languages | Nepali |
| Religion | Hindu |
Father's Mother
Education
| Level | Unknown |
| Degree | Not Completed |
| Occupation: | Homemaker |
Siblings:
| # Brothers | 2 |
| # Sisters | 4 |
Other:
| Languages | Nepali |
| Religion | Hindu |
Mother's Parents
Mother's Father
Education
| Level | Some High school |
| Degree | Not Completed |
| Occupation: | Priest |
Siblings:
| # Brothers | 2 |
| # Sisters | 3 |
Other:
| Languages | Nepali |
| Religion | Hindu |
Mother's Mother
Education
| Level | Unknown |
| Degree | Not Completed |
| Occupation: | Homemaker |
Siblings:
| # Brothers | 4 |
| # Sisters | 3 |
Other:
| Languages | Nepali |
| Religion | Hindu |