Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
|
Height:
5'8"
(172 cm) |
Weight:
160 lb
(72 kg) |
Eye Color:
Brown
|
Hair:
Black/
Straight |
Skin Tone:
Medium Light
|
Ancestry:
Asian
|
|
Blood Type:
O+
|
Ethnic Background:
Bangladeshi/Bangladeshi
|
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|
Education:
Pursuing BS/Civil Engineering
|
Occupation:
College Student
|
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|
Interests:
|
baking, Cooking, Crochet, Drawing, Track and Field, Video games
|
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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 - Pollen, watery eyes and runny nose |
| 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 | 47 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Migraines
29
Medication
Your Father
| Question | Response |
| Current age or age at death | 61 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Asthma
8
Inhaler
Brothers
Your Brother 1
| Question | Response |
| Current age or age at death | 17 |
| 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 | 23 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Asthma
1
Inhaler
Your Mother's Father
| Question | Response |
| Current age or age at death | 94 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Old age (passed away in his sleep) |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
No known health problems at time of death
Your Mother's Mother
| Question | Response |
| Current age or age at death | 88 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Old age (passed away in nursing home) |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
Received nursing care for dementia, age of diagnosis unknown
Your Mother's Sisters 1
| Question | Response |
| Current age or age at death | 62 |
| 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 | 55 |
| 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 | 58 |
| 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 | 101 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart failure |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
No other diagnosed health problems at time of death
Your Father's Mother
| Question | Response |
| Current age or age at death | 94 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Old age (passed away in sleep) |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
No known health problems at time of death
Your Father's Sisters 1
| 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's Brothers 1
| Question | Response |
| Current age or age at death | 54 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Religion:
| Faith | None |
| Denomination | N/A |
Updates to Profile
| Update Available | N/A |
| Updates - Personal | N/A |
| Updates - Medical | N/A |
| Updates - Family Medical History | N/A |