Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
6'5"
(195 cm) |
Weight:
278 lb
(126 kg) |
Eye Color:
Blue
|
Hair:
Brown/
Straight |
Skin Tone:
Light
|
Ancestry:
Caucasian
|
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Blood Type:
A-
|
Ethnic Background:
English-German/Irish
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Education:
MS/Information Systems
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Occupation:
IT Service Management
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Interests:
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Carpentry, Cooking, Dancing, Gardening, Rowing
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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, -2.5 both |
| 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 | 69 |
| 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 | 64 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Esophageal Cancer |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Kidney Stones
61
Ultrasound therapy, diet changes
Sisters
Your Sister 1
| Question | Response |
| Current age or age at death | 36 |
| 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 | 87 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Stroke, no treatment |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
No other diagnosed health problems at time of death
Your Mother's Mother
| Question | Response |
| Current age or age at death | 92 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Infection developed after injury from fall |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Any other sight/sound/smell disorder
80
Cataracts, treated with surgery
Your Mother'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 Mother's Brothers 2
| Question | Response |
| Current age or age at death | 65 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | COPD (smoker) |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
Used an oxygen tank to treat emphysema (age of diagnosis unknown)
Your Mother's Brothers 3
| Question | Response |
| Current age or age at death | 55 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Emphysema |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
No other diagnosed health problems at time of death
Your Father's Father
| Question | Response |
| Current age or age at death | 70 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Liver failure |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
No other diagnosed health problems at time of death
Your Father's Mother
| Question | Response |
| Current age or age at death | 70 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Pneumonia |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Breast cancer
55
Chemotherapy and radiation
Your Father's Sisters 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 Father's Sisters 2
| Question | Response |
| Current age or age at death | 64 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Specific cause unknown, poor lifestyle, avoided doctors |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
Suffered a back injury (age unknown) that prevented her from working
Your Father's Sisters 3
| 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 Brothers 1
| Question | Response |
| Current age or age at death | 75 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Religion:
| Faith | Christian |
| Denomination | Preysbaterian |
Updates to Profile
| Update Available | N/A |
| Updates - Personal | N/A |
| Updates - Medical | N/A |
| Updates - Family Medical History | N/A |