Height, cm: 161 Weight, kg: 65 Blood type and Rh factor: A (II) Rh- Ethinicity: russian Religion: christianity Character traits: Warm, kind, sociable, fun
Eye color: green Eye shape: european Nose: straight Forehead: normal (straight) Face: round Freckles/moles: yes
Hair type: wavy Hair color: chestnut-haired Grey hair: yes, started to appear from 28 years of age Constitution: mesomorphic (normal constitution) Right-handed or left-handed: right-handed
LIFE STYLE
Marital status: married Career field: working with delinquent youth Education: Higher Languages: russian, english
Favorite sport: dancing Play musical instruments: no Hobbies, interests: My main hobby is reading books, mostly on children’s and adolescent psychology
Why did I become a donor?
I joined the program because I really wanted to help couples with no children. It a great joy to have your own child, so I wanted to help couples that lost all hope in becoming parents.
Preferences
Favorite food: I like Russian and Ukranian cuisine Favorite color: blue, yellow Favorite season: autumn Favorite holiday: New Year’s Eve
Favorite book: “Eat, Pray, Love” by Elizabeth Gilbert Favorite music genre: Jazz Favorite film: “Timing of the shrew” Pets: an old cat
Information about children
Children: 1 Sex: girl Hearing/vision problems: no Mental health problems/autism: no ADHD/hyperactivity: no
Medical and genetic information
Please assess your dental health by 5-grade scale; 4 of 5
Have you ever worn braces?; No
Do you smoke?; No
Do you drink alcohol? How often?; Never
Do you have allergies? If you do, please, specify; For protein in cow’s milk
Do you take prohibited substances?; No
Have you ever had blood transfusion?; No
Have you ever been hospitalized?; Yes
Does your family history have twins or triplets?; No
Do you have Ashkenazi Jews as your ancestors?; No
Do you have chronic diseases? If you do, please, specify; Tonsillitis
Do you take any medications? If you do, please, specify; No
Have you or your blood relatives ever been diagnosed with any of the following diseases?
Diseases;Donor;Father;Mother;Brothers;Sisters;Grandfather / On father's side;Grandfather / On mother's side;Grandmother / On father's side;Grandmother / On mother's side