Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
5'10"
(177 cm) |
Weight:
253 lb
(114 kg) |
Eye Color:
Brown
|
Hair:
Black/
Straight |
Skin Tone:
Medium Light
|
Ancestry:
Latino
|
|
Blood Type:
A+
|
Ethnic Background:
Mexican/Mexican
|
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Education:
Pursuing AS/Criminal Justice
|
Occupation:
Student and Delivery Driver
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Interests:
|
Baseball, Broadway Shows, Drawing, Fishing, Football
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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: | Yes - Vicks, I get a rash |
| 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 | 65 |
| 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 | 35 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Accidental Fall |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Other
No diagnosed health problems at time of death
Sisters
Your Sister 1
| Question | Response |
| Current age or age at death | 35 |
| 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 | 99 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Heart attack
85
Stent
Your Mother's Mother
| Question | Response |
| Current age or age at death | 79 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart Attack |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Heart attack
70
Stent
Your Mother's Sisters 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 Sisters 2
| 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 1
| Question | Response |
| Current age or age at death | 77 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Progressive kidney disease
71
Dialysis
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 | 73 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Colon cancer
72
Chemotherapy
Your Father's Father
| Question | Response |
| Current age or age at death | 80 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Heart Attack |
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 | 85 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Sisters 1
| Question | Response |
| Current age or age at death | 50 |
| 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 | 47 |
| 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 | 48 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Religion:
| Faith | Christian |
| Denomination | Roman Catholic |
Updates to Profile
| Update Available | N/A |
| Updates - Personal | N/A |
| Updates - Medical | N/A |
| Updates - Family Medical History | N/A |