Physical
|
Height:
5'8"
(172 cm) |
Weight:
159 lb
(72 kg) |
Eye Color:
Brown
|
Hair:
Black/
Wavy |
Skin Tone:
Medium
|
Ancestry:
Caucasian
|
|
Blood Type:
O+
|
Ethnic Background:
Iraqi/Iraqi
|
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|
Education:
BM/Medicine & General Surgery
|
Occupation:
Pharmacy Technician
|
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Interests:
|
Ping pong, Swimming, Tennis
|
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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 | 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 | 59 | |
| Health Problem | Osteoarthritis (resulting from a car accident injury), treated with hip replacement surgery | 50 |
| Gallstones, treated with surgery | 55 | |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 62 | |
| Health Problem | Obesity, since his teens, no treatment | 13 |
| Renal failure (a result of political torture) treated with dialysis | 55 | |
| Heart failure treated with medication | 57 | |
| Cause of death: Pulmonary edema | 62 | |
| Living / Dead | Dead |
Sisters
Your Sister 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 33 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Sister 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 30 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 72 | |
| Health Problem | Heart attack, treated in hospital | 72 |
| Cause of death: Heart attack | 72 | |
| Living / Dead | Dead |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 75 | |
| Health Problem | Stroke, died in hospital | 75 |
| Cause of death: Stroke | 75 | |
| Living / Dead | Dead |
Your Mother's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 59 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 57 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 55 | |
| Health Problem | Depression, treated with medication | 40 |
| Living / Dead | Living |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 30 | |
| Health Problem | Healthy | |
| Iraq/Iran war casualty | 30 | |
| Living / Dead | Dead |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 74 | |
| Health Problem | Heart attack, no treatment | 74 |
| Cause of death: Heart attack | 74 | |
| Living / Dead | Dead |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 75 | |
| Health Problem | Lung cancer (heavy smoker), treatment unknown | 75 |
| Living / Dead | Dead |
Your Father's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 75 | |
| Health Problem | Allergic bronchitis, no treatment | 10 |
| Angina, treated with medication | 55 | |
| Heart attack, fatal, no treatment | 75 | |
| Cause of death: Heart attack | 75 | |
| Living / Dead | Dead |
Your Father's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 72 | |
| Health Problem | High cholesterol, treated with medication | 53 |
| Endometrial cancer, treated with chemotherapy and hysterectomy, now in remission | 60 | |
| Living / Dead | Living |
Your Father's Sisters 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 70 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 68 | |
| Health Problem | Obesity, since his teens, controlled with diet | 13 |
| Living / Dead | Living |
Religion:
| Faith | Islam |
| Denomination | N/A |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to donor Personal Profile: May 2017, November 2017. |
| Updates - Medical | No change to donor Medical Profile: May 2017, November 2017. |
| Updates - Family Medical History | No change to donor Family Medical History: May 2017, November 2017. |

Physical
Medical
Family Medical History
Religion
Updates to Profile