Height, cm: 165 Weight, kg: 54 Blood type and Rh factor: 0 (I) Rh+ Ethinicity: russian Religion: christianity Character traits: attentive, kind, responsible, caring, emotional, sensitive, modest
Eye color: brown Eye shape: european Nose: long Forehead: normal (straight) Face: oval Freckles/moles: no
Hair type: wavy 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: medicine Education: secondary vocational Languages: russian, basic english
Favorite sport: arm wrestling Play musical instruments: no Hobbies, interests: I am arm wrestler. At the moment am focused on general fitness
Why did I become a donor?
The idea of becoming a donor came to me unexpectedly. I realized that a lot of women can’t fall pregnant naturally and I can help them. Some friends tried to talk me out of, but I thought that if I can help somebody I should go ahead and do it. I really hope that you will get pregnant and have a healthy and happy baby very soon!
Preferences
Favorite food: sushi Favorite color: forest green Favorite season: winter Favorite holiday: New Year’s Eve
Favorite book: “Da Vinci Code “ by Dan Brown, “Girl with a Dragon tattoo” by Steig Larsson Favorite music genre: rap, pop music Favorite film: “Fluke”, “Method” Pets: a cat
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; 3 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; To pollen and to alcohol
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; Painkillers only if needed
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); ; 50; Breast cancer
Hemophilia;
Heart attacks;
Ulcer;
Ovarian cyst;
Ovarian tumors;
Fibroma of the uterus;
Uterine fibroids;
Alcoholism;
Drug addiction;
Diabetes up to 55 years;
Autism;
Other;