Physical
Height:
6'2"
(187 cm) |
Weight:
175 lb
(79 kg) |
Eye Color:
Blue
|
Hair:
Brown/
Straight |
Skin Tone:
Light
|
Ancestry:
Caucasian
|
Blood Type:
O-
|
Ethnic Background:
Irish-Italian/Irish-German
|
||||
Education:
MA/Education
|
Occupation:
Student
|
||||
Interests:
|
Lifting, Running, Sports
|
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 | 47 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father
Question | Response | Comment/Age Affected |
Current age or age at death | 49 | |
Health Problem | MCL surgery for a basketball injury | 49 |
Esophageal cancer diagnosed, about to begin chemotherapy and radiation | 49 | |
Living / Dead | Living |
Brothers
Your Brother 1
Question | Response | Comment/Age Affected |
Current age or age at death | 18 | |
Health Problem | Healthy | |
Living / Dead | Living |
Sisters
Your Sister 1
Question | Response | Comment/Age Affected |
Current age or age at death | 20 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Sister 2
Question | Response | Comment/Age Affected |
Current age or age at death | 16 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Father
Question | Response | Comment/Age Affected |
Current age or age at death | 76 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Mother
Question | Response | Comment/Age Affected |
Current age or age at death | 75 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Sisters 1
Question | Response | Comment/Age Affected |
Current age or age at death | 50 | |
Health Problem | Sporadic left hip pain, hip replacement surgery scheduled | 50 |
Living / Dead | Living |
Your Mother's Sisters 2
Question | Response | Comment/Age Affected |
Current age or age at death | 42 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Brothers 1
Question | Response | Comment/Age Affected |
Current age or age at death | 51 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Brothers 2
Question | Response | Comment/Age Affected |
Current age or age at death | 47 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Father
Question | Response | Comment/Age Affected |
Current age or age at death | 66 | |
Health Problem | Quadruple bypass surgery to treat clogged arteries | 65 |
Cause of death: Infection from bypass surgery | 66 | |
Living / Dead | Dead |
Your Father's Mother
Question | Response | Comment/Age Affected |
Current age or age at death | 72 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Sisters 1
Question | Response | Comment/Age Affected |
Current age or age at death | 51 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Sisters 2
Question | Response | Comment/Age Affected |
Current age or age at death | 45 | |
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 | 51 | |
Health Problem | Healthy | |
Living / Dead | Living |
Religion:
Faith | Christian |
Denomination | Roman Catholic |
Updates to Profile
Update Available | N/A |
Updates - Personal | N/A |
Updates - Medical | N/A |
Updates - Family Medical History | N/A |