Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
|
Height:
6'4"
(193 cm) |
Weight:
219 lb
(99 kg) |
Eye Color:
Brown
|
Hair:
Black/
Curly |
Skin Tone:
Medium Dark
|
Ancestry:
Multi
|
|
Blood Type:
O+
|
Ethnic Background:
English-Swedish-West Indian/English-Portuguese-West Indian
|
||||
|
Education:
MD/PhD
|
Occupation:
Radiology Resident
|
||||
|
Interests:
|
Family and friends, Music, Sports
|
||||
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: | Yes - Shellfish allergy |
| Do you wear glasses or contact lenses? Are you near or far-sighted? | Yes - Near-sighted, contacts |
| Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused: | Yes - Shellfish: Causes itchy throat; Seasonal allergies: Cause sneezing |
| 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 | 59 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Ovarian cancer |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Ovarian cancer
58
Chemotherapy
Your Father
| Question | Response |
| Current age or age at death | 60 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Trauma |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Trauma due to car crash
60
None
Brothers
Your Brother 1
| Question | Response |
| Current age or age at death | 40 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Brother 2
| Question | Response |
| Current age or age at death | 39 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Daughters
Your Daughter 1
| Question | Response |
| Current age or age at death | 2 |
| Living / Dead | Living |
Health Problems
Healthy
Your Mother's Father
| Question | Response |
| Current age or age at death | 95 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Trauma |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Trauma due to fall
95
None
Your Mother's Mother
| Question | Response |
| Current age or age at death | 88 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Organ failure |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Organ failure (age-related)
88
None
Your Mother's Sisters 1
| Question | Response |
| Current age or age at death | 70 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Sisters 2
| Question | Response |
| Current age or age at death | 62 |
| 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 | 65 |
| 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 | 63 |
| 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 | 82 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Organ failure |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Organ failure (age-related)
82
None
Your Father's Mother
| Question | Response |
| Current age or age at death | 88 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Organ failure |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Vascular dementia
86
None
Organ failure (age-related)
88
None
Your Father's Sisters 1
| Question | Response |
| Current age or age at death | 70 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Sisters 2
| Question | Response |
| Current age or age at death | 61 |
| 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 | 55 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart attack |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Heart attack
55
None
Your Father's Brothers 2
| Question | Response |
| Current age or age at death | 63 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Religion:
| Faith | Christian |
| Denomination | Episcopalian |
Updates to Profile
| Update Available | N/A |
| Updates - Personal | N/A |
| Updates - Medical | N/A |
| Updates - Family Medical History | N/A |