Favorite book: - Favorite music genre:Oriental music Favorite film: I like romantic movies. Pets: A dog, but don’t have any at home.
Information about children
Children: 2 Sex: girls 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?; 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