Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
6'1"
(185 cm) |
Weight:
185 lb
(83 kg) |
Eye Color:
Hazel
|
Hair:
Brown/
Wavy |
Skin Tone:
Medium
|
Ancestry:
Caucasian
|
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Blood Type:
A-
|
Ethnic Background:
English-Hungarian(Jewish)-Russian/German
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Education:
Pursuing AA/Business
|
Occupation:
Student
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Interests:
|
Acrobatics, Music, Traveling
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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 | 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 |
| Current age or age at death | 67 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father
| Question | Response |
| Current age or age at death | 43 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Car accident |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Trauma from car accident
43
Fatal
Brothers
Your Brother 1
| Question | Response |
| Current age or age at death | 45 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Sisters
Your Sister 1
| Question | Response |
| Current age or age at death | 40 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Father
| Question | Response |
| Current age or age at death | 62 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Body degeneration |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
PTSD
20
Treatment unknown
Your Mother's Mother
| Question | Response |
| Current age or age at death | 87 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | General health decline post-stroke at 85 |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Stroke
85
Palliative care
Your Father's Father
| Question | Response |
| Current age or age at death | 80 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Mother
| Question | Response |
| Current age or age at death | 80 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Religion:
| Faith | None |
| Denomination | Atheist |
Updates to Profile
| Update Available | N/A |
| Updates - Personal | N/A |
| Updates - Medical | N/A |
| Updates - Family Medical History | N/A |