Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
5'10"
(177 cm) |
Weight:
177 lb
(80 kg) |
Eye Color:
Brown
|
Hair:
Brown/
Straight |
Skin Tone:
Light
|
Ancestry:
Caucasian
|
|
Blood Type:
O+
|
Ethnic Background:
Czech-French/Polish
|
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|
Education:
MS/Software Engineering
|
Occupation:
Computer Engineer
|
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|
Interests:
|
Home remodeling and renovation, Investing, Real Estate
|
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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: | Yes - Penicillin: Causes rash |
| CMV IgG Antibody | Positive |
| 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 | 50 | |
| Health Problem | Migraines, formerly once or twice per year, treated by restricting caffeine intake | 30 |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 52 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Brothers
Your Brother 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 13 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Sisters
Your Sister 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 22 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Sister 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 18 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 84 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 81 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 56 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 48 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 46 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 4
| Question | Response | Comment/Age Affected |
| Current age or age at death | 45 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 5
| Question | Response | Comment/Age Affected |
| Current age or age at death | 43 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 54 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 42 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 40 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 85 | |
| Health Problem | Gout, treated with diet modification | 80 |
| Living / Dead | Living |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 85 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 62 | |
| 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 | 55 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Religion:
| Faith | None |
| Denomination | Atheist |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to donor Personal Profile: March 2014, November 2015. |
| Updates - Medical | Update received March 2014: The donor no longer consumes alcohol. No change to donor Medical Profile: November 2015. |
| Updates - Family Medical History | No change to donor Family Medical History: March 2014, November 2015. |