Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
5'8"
(172 cm) |
Weight:
175 lb
(79 kg) |
Eye Color:
Brown
|
Hair:
Black/
Curly |
Skin Tone:
Medium Light
|
Ancestry:
Latino
|
|
Blood Type:
A+
|
Ethnic Background:
Hispanic/Colombian/Hispanic/Colombian
|
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|
Education:
BS/Business Administration
|
Occupation:
Real Estate Agent
|
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|
Interests:
|
Exercising, Reading
|
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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 | 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 | Comment/Age Affected |
| Current age or age at death | 65 | |
| Health Problem | Cause of death: Automobile accident | 65 |
| Living / Dead | Dead |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 66 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Brothers
Your Brother 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 44 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Sisters
Your Sister 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 42 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Sister 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 40 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Daughters
Your Daughter 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 8 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 80 | |
| Health Problem | Cause of death: Horseback riding accident | 80 |
| Living / Dead | Dead |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 85 | |
| Health Problem | Cause of death: Heart failure | 85 |
| Living / Dead | Dead |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 67 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 61 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 87 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 80 | |
| Health Problem | Cause of death: Natural causes | 80 |
| Living / Dead | Dead |
Your Father's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 65 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Religion:
| Faith | Christian |
| Denomination | Catholic |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to donor Personal Profile: June 2012, July 2015, September 2016. |
| Updates - Medical | No change to donor Medical Profile: June 2012, July 2015, September 2016. |
| Updates - Family Medical History | No change to donor Family Medical History: June 2012, July 2015. Update received September 2016: Paternal grandfather died at age 101 of a heart attack. |