Physical
Height:
6'0"
(182 cm) |
Weight:
185 lb
(83 kg) |
Eye Color:
Brown
|
Hair:
Brown/
Curly |
Skin Tone:
Medium Light
|
Ancestry:
Caucasian
|
Blood Type:
O+
|
Ethnic Background:
English-Polish/English-German
|
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Education:
Pursuing BS/Aerospace Engineer
|
Occupation:
Math Tutor
|
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Interests:
|
Bowling, Reading, Skiing, Travel, Video games
|
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 - Far-Sighted, 2.0/ 2.0 |
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 | 50 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
Age 36, Age 45, Age 47, Surgery for herniated disc due to military duty, physical therapy
Your Father
Question | Response |
Current age or age at death | 49 |
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 | 22 |
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
Disease
Age Diagnosed
Treatment For Condition
Other
Gallbladder removed, Age 75
Your Mother's Mother
Question | Response |
Current age or age at death | 77 |
Living / Dead | Living |
Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Breast cancer
70
Mastectomy
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 Father's Father
Question | Response |
Current age or age at death | 70 |
Living / Dead | Dead |
Cause of death and any treatment prior to death | Melanoma metastasized and caused Leukemia, Age 70, Chemotherapy and removal of melanoma |
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 | 76 |
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 |