Height, cm: 160 Weight, kg: 47 Blood type and Rh factor: 0 (I) Rh + Ethinicity: russian Religion: christianity Character traits: Focused, decisive
Eye color: Green - Brown Eye shape: european Nose: straight Forehead:Medium Face: Oval Freckles/moles: In summer
Hair type: Curly Hair color: Dirty blond Grey hair: no Constitution: mesomorphic (normal constitution) Right-handed or left-handed: right-handed
LIFE STYLE
Marital status: Married Career field: Own business Education: Secondary Vocational, Higher Languages: Russian, English
Favorite sport: Swimming Play musical instruments: no Hobbies, interests: Swimming
Why did I become a donor?
Preferences
Favorite food: Sweet, salty, spicy! Favorite color: White Favorite season: summer Favorite holiday: My birthday and New Year’s Eve
Favorite book: “An Honest Thieve” by Fyodor Dostoevsky Favorite music genre: Electronic music
Favorite film: “The Green Mile” Pets: A Bengal 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; 4 of 5
Have you ever worn braces?; No
Do you smoke?; No
Do you drink alcohol? How often?; No
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