Physical
Height:
5'9"
(175 cm) |
Weight:
190 lb
(86 kg) |
Eye Color:
Brown
|
Hair:
Black/
Wavy |
Skin Tone:
Medium Light
|
Ancestry:
Latino
|
Blood Type:
O+
|
Ethnic Background:
Venezuelan/Venezuelan
|
||||
Education:
High School Diploma
|
Occupation:
Realtor
|
||||
Interests:
|
Basketball, Cooking, Football, Guitar, Keyboard, Reading. Hiking
|
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 |
Current age or age at death | 54 |
Living / Dead | Dead |
Cause of death and any treatment prior to death | Car accident |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
No diagnosed health problems at time of death
Your Father
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
Your Mother'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 Mother's Mother
Question | Response |
Current age or age at death | 82 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Sisters 1
Question | Response |
Current age or age at death | 53 |
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 | 54 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Brothers 2
Question | Response |
Current age or age at death | 52 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Brothers 3
Question | Response |
Current age or age at death | 48 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Brothers 4
Question | Response |
Current age or age at death | 44 |
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 | 78 |
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 | 79 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Sisters 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
Your Father's Brothers 1
Question | Response |
Current age or age at death | 53 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Brothers 2
Question | Response |
Current age or age at death | 51 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Brothers 3
Question | Response |
Current age or age at death | 43 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Religion:
Faith | Christian |
Denomination | Jehovah's Witness |
Updates to Profile
Update Available | N/A |
Updates - Personal | N/A |
Updates - Medical | N/A |
Updates - Family Medical History | N/A |