Physical
Height:
6'4"
(193 cm) |
Weight:
174 lb
(78 kg) |
Eye Color:
Brown
|
Hair:
Black/
Straight |
Skin Tone:
Medium
|
Ancestry:
Multi
|
Blood Type:
O+
|
Ethnic Background:
Mexican/Czech-English
|
||||
Education:
BS/Computer Science
|
Occupation:
Student, Safety Inspector
|
||||
Interests:
|
I enjoy playing basketball with my roommates, playing video games and studying for my classes
|
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 - Mild pollen allergy: Causes sneezing |
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 | 47 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father
Question | Response | Comment/Age Affected |
Current age or age at death | 50 | |
Health Problem | Healthy | |
Living / Dead | Living |
Brothers
Your Brother 1
Question | Response | Comment/Age Affected |
Current age or age at death | 17 | |
Health Problem | Healthy | |
Living / Dead | Living |
Sisters
Your Sister 1
Question | Response | Comment/Age Affected |
Current age or age at death | 26 | (paternal half sister) |
Health Problem | Healthy | |
Living / Dead | Living |
Your Sister 2
Question | Response | Comment/Age Affected |
Current age or age at death | 23 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Father
Question | Response | Comment/Age Affected |
Current age or age at death | 35 | |
Health Problem | Healthy | |
Cause of death: Factory accident | 35 | |
Living / Dead | Dead |
Your Mother's Mother
Question | Response | Comment/Age Affected |
Current age or age at death | 72 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Brothers 1
Question | Response | Comment/Age Affected |
Current age or age at death | 45 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Father
Question | Response | Comment/Age Affected |
Current age or age at death | 82 | |
Health Problem | Back pain, occasional, due to age (treatment unknown) | 60 |
Living / Dead | Living |
Your Father's Mother
Question | Response | Comment/Age Affected |
Current age or age at death | 85 | |
Health Problem | Alzheimer's, treated in assisted care | 84 |
Living / Dead | Living |
Your Father's Sisters 1
Question | Response | Comment/Age Affected |
Current age or age at death | 56 | Half sister |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 1
Question | Response | Comment/Age Affected |
Current age or age at death | 60 | Half brother |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 2
Question | Response | Comment/Age Affected |
Current age or age at death | 57 | Half brother |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 3
Question | Response | Comment/Age Affected |
Current age or age at death | 52 | |
Health Problem | Healthy | |
Living / Dead | Living |
Religion:
Faith | Christian |
Denomination | Catholic |
Updates to Profile
Update Available | N/A |
Updates - Personal | N/A |
Updates - Medical | N/A |
Updates - Family Medical History | N/A |