Height, cm: 174 Weight, kg: 75 Blood type and Rh factor: B (III) Rh+ Ethinicity: caucasian Religion: christianity Character traits: I am kind, honest, fair
Eye color: brown Eye shape: european Nose: straight Forehead: normal (straight) Face: triangular Freckles/moles: yes
Hair type: straight Hair color: chestnut-haired Grey hair: no Constitution: mesomorphic (normal constitution) Right-handed or left-handed: right-handed
LIFE STYLE
Marital status: single Career field: - Education: higher incomplete Languages: russian, a bit of ukranian, basic english
Favorite sport: running, fitness Play musical instruments: no Hobbies, interests: movies, good food, family
Why did I become a donor?
I have become a donor for one very simple reason – I wanted to help other people to be as happy as I am by being a mother. It is the most important thing in the world!
Preferences
Favorite food: anything with cheese in it and cheese itself. Potatoes, meat, vegetables Favorite color: blue Favorite season: winter Favorite holiday: New Year’s Eve
Favorite book: “Jane Eyre” by Charlotte Bronte Favorite music genre: I like all sorts of music, depending on my mood Favorite film: “An interview with a vampire” Pets: a cat
Information about children
Children: 2 Sex: boys Hearing/vision problems: no Mental health problems/autism: no ADHD/hyperactivity: Yes
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?; Sometimes
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?; No
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); ;40
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;