Physical
Height:
5'10"
(177 cm) |
Weight:
151 lb
(68 kg) |
Eye Color:
Blue
|
Hair:
Brown/
Straight |
Skin Tone:
Medium Light
|
Ancestry:
Caucasian
|
Blood Type:
O+
|
Ethnic Background:
Polish/German-Irish
|
||||
Education:
DMD/Dentistry
|
Occupation:
Student
|
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Interests:
|
climb, Hang out with my friends, Hike, kayak, Play the guitar, Read, ride my bike
|
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 |
Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused: | Yes - Pollen: Causes stuffy nose, watery eyes; Cats (mild): Cause: Itchy, watery eyes with long exposure |
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 | Comment/Age Affected |
Current age or age at death | 57 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father
Question | Response | Comment/Age Affected |
Current age or age at death | 58 | |
Health Problem | Healthy | |
Living / Dead | Living |
Sisters
Your Sister 1
Question | Response | Comment/Age Affected |
Current age or age at death | 28 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Sister 2
Question | Response | Comment/Age Affected |
Current age or age at death | 26 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Sister 3
Question | Response | Comment/Age Affected |
Current age or age at death | 20 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Father
Question | Response | Comment/Age Affected |
Current age or age at death | 73 | |
Health Problem | Pneumonia, treated in hospital | 73 |
Cause of death: Pneumonia | 73 | |
Living / Dead | Dead |
Your Mother's Mother
Question | Response | Comment/Age Affected |
Current age or age at death | 85 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Brothers 1
Question | Response | Comment/Age Affected |
Current age or age at death | 59 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Brothers 2
Question | Response | Comment/Age Affected |
Current age or age at death | 54 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Brothers 3
Question | Response | Comment/Age Affected |
Current age or age at death | 51 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Father
Question | Response | Comment/Age Affected |
Current age or age at death | 56 | |
Health Problem | High blood pressure, no treatment | 56 |
High cholesterol, no treatment | 56 | |
Heart attack, fatal, no treatment | 56 | |
Coronary heart disease (diagnosed post-mortem) | 56 | |
Cause of death: Heart attack | 56 | |
Living / Dead | Dead |
Your Father's Mother
Question | Response | Comment/Age Affected |
Current age or age at death | 83 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Sisters 1
Question | Response | Comment/Age Affected |
Current age or age at death | 59 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 1
Question | Response | Comment/Age Affected |
Current age or age at death | 61 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 2
Question | Response | Comment/Age Affected |
Current age or age at death | 55 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 3
Question | Response | Comment/Age Affected |
Current age or age at death | 54 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 4
Question | Response | Comment/Age Affected |
Current age or age at death | 51 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 5
Question | Response | Comment/Age Affected |
Current age or age at death | 49 | |
Health Problem | Healthy | |
Living / Dead | Living |
Religion:
Faith | Other |
Denomination | Agnostic |
Updates to Profile
Update Available | Yes |
Updates - Personal | No change to donor Personal Profile: April 2017, October 2017, September 2020. |
Updates - Medical | No change to donor Medical Profile: April 2017, October 2017, September 2020. |
Updates - Family Medical History | No change to donor Family Medical History: April 2017, October 2017, September 2020. |