Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
6'1"
(185 cm) |
Weight:
166 lb
(75 kg) |
Eye Color:
Green
|
Hair:
Blond/
Straight |
Skin Tone:
Medium Light
|
Ancestry:
Caucasian
|
|
Blood Type:
A+
|
Ethnic Background:
Polish/Russian
|
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Education:
BS/Environmental Sciences
|
Occupation:
Student
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Interests:
|
Camping, Running. Swimming, Triathlons
|
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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 | 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 |
| Current age or age at death | 59 |
| 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 | 65 |
| 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 | 27 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Father
| Question | Response |
| Current age or age at death | 88 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart Disease |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Heart Disease
85
Diet, exercise
High Cholesteral
85
Cholesterol lowering meds
Your Mother's Mother
| Question | Response |
| Current age or age at death | 90 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Cancer |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Cancer, unknown type
78
Radiation
Your Mother's Brothers 1
| Question | Response |
| Current age or age at death | 64 |
| 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 | 86 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart Disease - Surgery and medication |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
High Cholesterol
80
Diet, exercise, cholesterol lowering medication
Heart Disease
82
Surgery
Your Father's Mother
| Question | Response |
| Current age or age at death | 91 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart Disease and Cancer - Radiation |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Heart Disease
87
Unknown
Cancer, unknown type
87
Radiation
Your Father's Brothers 1
| Question | Response |
| Current age or age at death | 67 |
| 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 | 64 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
High cholesterol
62
Cholesterol lowering medication
Religion:
| Faith | Other |
| Denomination | Agnostic |
Updates to Profile
| Update Available | N/A |
| Updates - Personal | N/A |
| Updates - Medical | N/A |
| Updates - Family Medical History | N/A |