Height, cm: 160 Weight, kg: 58 Blood type and Rh factor: 0 (I) Rh+ Ethinicity: russian Religion: christianity Character traits: I am kind, warm, caring, friendly, responsible
Eye color: green Eye shape: european Nose: straight Forehead: normal (straight) Face: oval Freckles/moles: yes
Hair type: wavy Hair color: dirty-blonde Grey hair: no Constitution: mesomorphic (normal constitution) Right-handed or left-handed: left-handed
LIFE STYLE
Marital status: married Career field: sales Education: secondary vocational Languages: russian, english
Favorite sport: athletics Play musical instruments: no Hobbies, interests: DIY, crochet, reading, outdoor activities
Why did I become a donor?
I became a donor to help couples that can’t have children. It is my life’s motto – if I can help someone, I have to do it! For all the parents to be I wish love and happiness!
Preferences
Favorite food: russian cuisine Favorite color: green Favorite season: spring Favorite holiday: New Year’s Eve
Favorite book: - Favorite music genre: pop music Favorite film: “Titanic” Pets: hamsters
Information about children
Children: 1 Sex: boy 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?; Rarely
Do you have allergies? If you do, please, specify; No
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; No
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
Migraine;
Mental disorders;
Epilepsy;
Muscular dystrophy;
Hearing problems/deafness;
Daltonism/blindness;
Hyperopia/myopia;
Glaucoma;
Mental disorders;
Frequent depression;
Congenital disorders;
Clubfoot;
Dwarfism;
Cardiovascular disease;
More than two miscarriages;
Skin pigmentation disorders - vitiligo;
Psoriasis, neurodermatitis, skin hyperpigmentation;
Hair loss (age);
Oncological diseases (specify type);
Hemophilia;
Heart attacks; ; ; ; ; ; ; +
Ulcer;
Ovarian cyst;
Ovarian tumors;
Fibroma of the uterus;
Uterine fibroids;
Alcoholism;
Drug addiction;
Diabetes up to 55 years;
Autism;
Other;