Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
5'10"
(177 cm) |
Weight:
155 lb
(70 kg) |
Eye Color:
Brown
|
Hair:
Brown/
Wavy |
Skin Tone:
Light
|
Ancestry:
Caucasian
|
|
Blood Type:
O+
|
Ethnic Background:
German-Italian/Polish-German
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Education:
BS/Management
|
Occupation:
Senior Manager
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Interests:
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Astronomy, Biking, Cooking, Fishing, Guitar, Hiking, Rock Climbing
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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 - Near-sighted, 20/40 |
| Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused: | Yes - Penicillin, 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 |
| Current age or age at death | 68 |
| 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 | 69 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Brothers
Your Brother 1
| Question | Response |
| Current age or age at death | 42 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Brother 2
| Question | Response |
| Current age or age at death | 41 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Sons
Your Son 1
| Question | Response |
| Current age or age at death | 4 |
| Living / Dead | Living |
Health Problems
Healthy
Your Mother's Father
| Question | Response |
| Current age or age at death | 82 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Complications from Alzheimer's |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Alzheimer's
78
Nursing care
Your Mother's Mother
| Question | Response |
| Current age or age at death | 92 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart Failure |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other disease of the kidney, urinary tract, urethra, bladder, ureter
85
Bladder infections treated with antibiotics
Osteoarthritis
50
Physical therapy and medication
Your Mother's Sisters 1
| Question | Response |
| Current age or age at death | 73 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Sisters 2
| Question | Response |
| Current age or age at death | 71 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Sisters 3
| Question | Response |
| Current age or age at death | 65 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Brothers 1
| Question | Response |
| Current age or age at death | 60 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Father
| Question | Response |
| Current age or age at death | 65 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart Failure |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
Work related joint pain, and frequent bladder infections
Your Father's Mother
| Question | Response |
| Current age or age at death | 91 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Complications from old age |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
No known diagnosed health problems at time of death
Your Father's Sisters 1
| Question | Response |
| Current age or age at death | 68 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Religion:
| Faith | Christian |
| Denomination | Catholic |
Updates to Profile
| Update Available | N/A |
| Updates - Personal | N/A |
| Updates - Medical | N/A |
| Updates - Family Medical History | N/A |