Physical
|
Height:
5'9"
(175 cm) |
Weight:
159 lb
(72 kg) |
Eye Color:
Brown
|
Hair:
Black/
Straight |
Skin Tone:
Medium
|
Ancestry:
Asian
|
|
Blood Type:
B+
|
Ethnic Background:
Chinese/Chinese
|
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|
Education:
MBA
|
Occupation:
Acct. Executive, Student
|
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|
Interests:
|
Fencing, Tennis, Weights
|
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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? | Yes |
| Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused: | Yes - Pollen, seasonal |
| 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 | 59 | |
| Health Problem | High blood pressure | 55 |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 61 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Brothers
Your Brother 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 24 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Sisters
Your Sister 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 28 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 42 | |
| Health Problem | Cause of death: Execution during Communist revolution | 42 |
| Living / Dead | Dead |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 76 | |
| Health Problem | Unknown, died in rural China | 76 |
| Living / Dead | Dead |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 62 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 58 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 79 | |
| Health Problem | Unknown, died in rural China | 79 |
| Living / Dead | Dead |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 89 | |
| Health Problem | Unknown, died in rural China | 89 |
| Living / Dead | Dead |
Your Father's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 55 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 47 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Sisters 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 42 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 58 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 54 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 38 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 4
| Question | Response | Comment/Age Affected |
| Current age or age at death | 35 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
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 |

Physical
Medical
Family Medical History
Religion
Updates to Profile