Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
6'1"
(185 cm) |
Weight:
170 lb
(77 kg) |
Eye Color:
Green
|
Hair:
Black/
Straight |
Skin Tone:
Medium Dark
|
Ancestry:
Caucasian
|
|
Blood Type:
B+
|
Ethnic Background:
French-Italian-Spanish/Italian-Spanish
|
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|
Education:
MS/Chemistry
|
Occupation:
Student
|
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Interests:
|
Gardening, Health & Nutrition
|
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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? | Yes - Near-sighted |
| 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 | 66 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father
| Question | Response |
| Current age or age at death | 73 |
| 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 | 46 |
| 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 | 44 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Brother 3
| Question | Response |
| Current age or age at death | 31 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Sisters
Your Sister 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
Daughters
Your Daughter 1
| Question | Response |
| Current age or age at death | 6 |
| Living / Dead | Living |
Health Problems
Healthy
Your Mother's Father
| Question | Response |
| Current age or age at death | 92 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Pneumonia |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Pneumonia
92
Unknown
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 | Pneumonia |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Pneumonia
88
Unknown
Your Mother's Sisters 1
| Question | Response |
| Current age or age at death | 62 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart valve disease |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Rheumatic fever
12
Unknown
Heart valve disease (due to rheumatic fever)
62
Heart valve replacement surgery (three times)
Your Mother's Sisters 2
| Question | Response |
| Current age or age at death | 78 |
| 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 | 80 |
| 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 | 76 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Brothers 3
| Question | Response |
| Current age or age at death | 72 |
| 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 | Natural causes |
Health Problems
Healthy
Your Father's Mother
| Question | Response |
| Current age or age at death | 77 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Liver cancer |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Liver cancer
77
None
Your Father's Brothers 1
| 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
Healthy
Your Father's Brothers 2
| 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 3
| 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
Religion:
| Faith | None |
| Denomination | (Raised Catholic) |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to Personal Profile: August 2019, June 2020. |
| Updates - Medical | No change to Medical Profile: August 2019, June 2020. |
| Updates - Family Medical History | No change to Family Medical History: August 2019, June 2020. |