EXPANDED PROFILE : Eve325

Transcription

1 EPANDED PROFILE : Eve325

2 SOME INTERESTING FACTS ABOUT: YOUR STAR SIGN: WHAT DO YOU CONSIDER AS YOUR BEST FACIAL FEATURE: WHAT DO YOU CONSIDER TO BE YOUR BEST PHYSICAL FEATURE: HOW WOULD YOU DESCRIBE YOUR SMILE: HOW WOULD YOU DESCRIBE YOUR LAUGH: WHICH ACTRESS OR FAMOUS PERSON YOU THINK YOU RESEMBLE: Eve325 Sagittarius Lips and Skin Petite and curvaceous frame Contagious, warm and friendly Heart-warming Demi Moore FAVOURITES FOOD/S: BOOK/S: Ferrari MOVIE/S: SONG/S: DO YOU PLAY A MUSICAL INSTRUMENT? FAVOURITE MUSICAL INSTRUMENT: ACTOR/ESS: COLOUR: CAR: FLOWER: GEM STONE: ANIMAL: TIME OF DAY: SEASON: DESTINATION: HISTORICAL FIGURE: PERSON YOU WOULD MOST LIKE TO MEET: WHY? FAVOURITE SCHOOL: ANY SPECIAL AWARDS/ACHIEVEMENTS: FAVOURITE QUOTE: PERSONAL PREFERENCES/ABILITIES ARE YOU SKILLED: HOW WOULD YOU RATE YOUR ABILITY IN MATH: LITERARY SKILLS: SCIENTIFIC/ RESEARCH ABILITIES: ARTICTIC TALENTS: MUSIC SKILLS / ABILITIES: ATHLETIC ABILITIES: HOW MANY LANGUAGES CAN YOU SPEAK? Healthy home-cooked meals The Monk Who Sold His Action/Comedy/Ro mance/horror Songs with deep meaning Piano Violin/Guitar/Piano Jennifer Aniston/Jason Statham/Liam Neeson Yellow Audi/Mercedes Lily Topaz Dog/Cat Night Winter and Spring Seychelles or anything on a yacht Richard Branson Ashton Kutcher Just to see him smile Travel and Tourism/English/Biology Excelled in Speech & Drama and Modelling Always give without expecting anything in return MECHANICALLY / TECHNICALLY English and Afrikaans

3 SPECIAL SKILLS & PERSONALITY OF FAMILY MEMBERS Music / Artistic / Athletic / Scientific / Math skills / Personality / Employment / Hobbies / Other interesting facts MOTHER: My mother is retired. She is a very caring and supportive person. She is generous and always helpful to others. She is a great cook, loves being in the kitchen and is always cooking up a storm. She is quite artistic and loves helping her grandchildren with school projects. FATHER: My father was a Jack of All Trades. He appeared hard on the inside but was actually a real softy. He was very good with numbers, very technical and also very mechanically skilled. He loved to listen to music and dance. BROTHER/S: My oldest brother competed in bodybuilding competitions and now owns his own personal fitness gym together with his wife. He is competitively involved in mountain bike racing. He loves swimming and just staying active. We get along very well. My other brother is a mechanic. He is kind-hearted. He is very active. He loves to play rugby and cricket. I don t know my half-brother as I have only met him once. SISTER/S: My sister is a teacher and qualified bookkeeper. She has a soft heart. She has two girls and loves being a mom. CHILDREN: My eldest son is a very intelligent boy. He loves being active by playing sports, music, dancing and fixing things. He is very artistic and also technically and mechanically skilled. My daughter is very busy She loves reading, painting, writing and using her imagination. She is also very independent and loves cuddle time. My second son is very sweet. He looks up to his oldest brother, and shares everything. My youngest son is very gregarious He loves playing with his siblings. DONORS HANDWRITING SAMPLE KEIRSEY TEMPERAMENT: GUARDIAN Guardians are the cornerstone of society, for they are the temperament given to serving and preserving our most important social institutions. Guardians have natural talent in managing goods and services--from supervision to maintenance and supply -- and they use all their skills to keep things running smoothly in their families, communities, schools, churches, hospitals, and businesses. All Guardians share the following core characteristics: Guardians pride themselves on being dependable, helpful, and hard-working.guardians make loyal mates, responsible parents, and stabilizing leaders. Guardians tend to be dutiful, cautious, humble, and focused on credentials and traditions. Guardians are concerned citizens who trust authority, join groups, seek security, prize gratitude, and dream of meting out justice. Guardians can have a lot of fun with their friends, but they are quite serious about their duties and responsibilities. Guardians take pride in being dependable and trustworthy; if there's a job to be done, they can be counted on to put their shoulder to the wheel. Guardians also believe in law and order and sometimes worry that respect for authority even a fundamental sense of right and wrong, is being lost. Perhaps this is why Guardians honour customs and traditions so strongly -- they are familiar patterns that help bring stability to our modern, fast-paced world. Practical and down-to-earth, Guardians believe in following the rules and cooperating with others. They are not very comfortable winging it or blazing new trails; working steadily within the system is the Guardian way, for in the long run loyalty, discipline, and teamwork get the job done right. Guardians are meticulous about schedules and have a sharp eye for proper procedures. They are cautious about change, even though they know that change can be healthy for an institution. Better to go slowly, they say, and look before you leap. Guardians make up as much as 40 to 45 percent of the population, and a good thing, because they usually end up doing all the indispensable but thankless jobs the rest of the population takes for granted. Guardian Portraits: Mother Teresa, William Howard Taft, Harry S. Truman, George Washington

4 FACIAL CHARACTERISTICS Face Shape: Inverted Triangle Eye Shape: Hooded / Down Turned / Almond / Round / Protruding Eye Set: Narrow / Close / Average / Deep/ Wide Eye Size: Small / Average / Large Eye colour: Green Lip Shape: Full / Thin / Flat upper Lip / Perfect / Large top lip / Droopy shape Nose Shapes: Wavy / Snub / Flat / Aquiline / Upturned / Straight Hair Line: Straight / Round / Widow s Peak Hair form: Wavy / Slightly Curly / Straight / Ethnic Hair Texture: Average / Thick / Fine / Coarse / Thin Hair Colour: Light Brown Premature Graying: Yes / No, If yes, at what age: N/A Present hair loss: None / Thinning Complexion: Fair Tan Ability: None / Slight / Medium / Easy Cheek Bones: High / Low / Wide / Flat / Pointed Facial Features: Moles / Freckles / Dimples / Beauty Spots / Cleft Chin / Gap tooth /Overbite/ None PHYSICAL CHARACTERISTICS Body Shape: Neat Hour Glass Height: 1.60m Weight: 50.0kg BMI: 23.4 Build: Petite/Small/Medium/Athletic/Large/Stocky Hands: Right-handed/Left-handed/Ambidextrous

5 MEDICAL PROFILE PERSONAL HEALTH HISTORY Blood Group (ABO): B Rhesus: + Are you adopted? No Are either of your parents adopted? No Vision (without corrective lenses): Poor / Fair / Good / Excellent Do you wear corrective lenses? No If yes, for what problem(s)? Farsighted / Short-sighted / Other: Explain: N/A Hearing (without corrective aids): Poor / Fair / Good / Excellent Do you wear corrective aids? N/A If yes, for what problems? N/A Do you smoke cigarettes? No If yes, how many per day? N/A Do you drink alcohol? Yes If yes, how often? Occasionally Diet: Vegetarian / Non vegetarian / Other: N/A Allergies: No If yes, are they to: Food(s) / Medication(s) / Cosmetics / Environmental / Animals / Insects For each allergy, describe specific substance and reaction(s) and age first noticed: Substance: N/A Reaction(s): N/A Age: N/A Explain allergies you have outgrown: N/A Exercise/ Sporting activities: None / Occasional / Regular Type of Exercise: Squash, tennis, swimming and jogging Have you had any surgery (ies)? Yes If yes please explain: 2012: Caesarean section Have you had any hospitalisation(s) not mentioned above? No Have you had a blood transfusion? No Are you a blood donor? No Have you ever been excluded from blood donation for reason of infectious disease? No Have you had major radiation or x-ray exposure? No If yes, explain: N/A Have you had any psychological or psychiatric care? No If yes, explain: N/A Are you currently taking any medications, prescribed or over the counter? No If yes, please list: N/A Are you currently using any recreational drugs? No If yes, please list: N/A Do you have any physical deformities for which you have sought surgical corrections? No If so, please explain: N/A

6 Have you ever been tested as a carrier of? Tay-Sach s disease Sickle Cell disease Thalassemia Cystic Fibrosis Carrier Non-carrier Unknown CF d508 FERTILITY HISTORY AMH: AFC: Not tested, as AFC was found to be adequate by a fertility specialist Measured Have you ever been pregnant? Yes Do you have any children? Yes If yes, please complete below: Sex: Male Year of birth: 2008 Health Status: Excellent Sex: Female Year of birth: 2010 Health Status: Excellent Sex: Male Year of birth: 2013 Health Status: Excellent Sex: Male Year of birth: 2017 Health Status: Excellent Any special comments concerning your children? Excellent health Are you currently on any form of birth control? No Do you have a regular period? Yes Is there any history of fertility problems in your family (difficulty conceiving or miscarriages)? No PSYCHOLOGICAL ASSESSMENT All our donors undergo psychological screening prior to their first donation. This assessment and subsequent assessments are valid for one year. SEUAL HEALTH HISTORY Have you or any of your sexual partner been in contact with anyone or have personally been treated for any of the following: NO TO ALL Self Partner When HIV NSU (non specific urethritis) Syphilis Gonorrhea Chlamydia Venereal Warts Herpes Viral Hepatitis B or C Hemophilia Received human-derived clotting factor concentrates IV (intravenous) drug use Other sexually transmitted diseases Do you practice safe sex at all times? Yes Do you consider your sexual practices risky for HIV infection? No Have you or any of your sexual partners: -engaged in sexual relations with a partner of the same sex during the last 5 years? No -had sex in exchange for money or drugs in the preceding 5 years? No -within the past 12 months undergone tattooing, acupuncture, ear or body piercing? No

7 Year of Birth Health Status Age at time of Death Cause of Death Eye Colour Hair Colour Complexion Height (m) Weight (kg) Build FAMILY BIO/HISTORY Mother Blue Brown Fair Medium Father 1957 Deceased 54 Cardiac Arrest Green Black Medium Small Brother 1 Brother 2 Half Brother Blue Black Medium Medium Green Black Medium Black Sister Blue Brown Medium Medium Child Blue Blond Fair Still - Still growing growing Child Blue Blond Fair Still - Still growing growing Child Green Blond Fair Still - Still growing growing Child Blue Blond Fair Still - Still growing growing MGM - Deceased 74 Unknown Blue Brown Fair Medium MGF - Deceased 54 Car accident Blue Dark brown Medium Medium PGM - Deceased 76 Unknown Green Brown Fair Small PGF Blue Brown Fair Medium (MGM = Maternal Grandmother, MGF = Maternal Grandfather, PGM = Paternal Grandmother, PGF = Paternal Grandfather, - = Unknown) How many blood siblings are in your immediate family (including yourself)? 4 Number of Males: 2 Number of Females: 2 How many half siblings are in your immediate family? 1 If so, from which parent? Father Number of Males: 1 Number of Females: 0 How many adopted siblings are in your immediate family (including yourself)? 0 Number of Males: 0 Number of Females: 0 Are there any twins or triplets in your family? No Are there any known genetic diseases or conditions that run in your family? No Have you or any family members described above had genetic counseling? No Are there any members of your family with a history of learning disabilities? No

8 Medical problems which are present in biological family members: You Mother Father Sibling MGM MGF PGM PGF HEART Stroke Heart attack Heart disease or defect 1. from birth 2. other Hardening of the arteries High blood pressure Hereditary high cholesterol High cholesterol level BLOOD Anemia Sickle-cell anemia Hemophilia/bleeding disorder HIV / AIDS Leukemia Other blood disorder RESPIRATORY Asthma Lung cancer Emphysema Tuberculosis GASTRO-INTESTINAL Ulcer of stomach/duodenum Hepatitis (all types) Cirrhosis Other liver disease Ulcerative colitis Crohn's disease Pyloric stenosis Multiple Polyposis of colon Rectal disorder METABOLIC/ENDOCRINE Diabetes (age of onset) Thyroid disease Goiter Hyperactivity Phenyl Ketonuria (PKU) Cystic fibrosis Dwarfism Lupus/other auto immune diseases URINARY Kidney disease Other disease/defect of urinary tract Mother diagnosed with High Blood Pressure and Migraines. Donor diagnosed with Anaemia. Father died of a heart attack at age 54.

9 NEUROLOGICAL Migraines Mental retardation Senility before age 50 Multiple Sclerosis Cerebral Palsy Epilepsy/seizure Hydrocephalus Spina bifida neural tube defect Tuberous Sclerosis Parkinsonism Creutzfeldt-Jakob Disease Scoliosis MENTAL HEALTH Depression Schizophrenia Manic depressive/bipolar disorder Alcoholism Drug abuse, misuse or addiction MUSCLE/BONE/JOINTS Muscular dystrophy Loss of muscle coordination Other chronic muscle disease Osteoporosis Marfan Syndrome Arthritis SIGHT/SOUND/SMELL Deafness before age 60 Deformity of the ear Cataracts before age 50 Blindness Colour blindness Severe Myopia Glaucoma Retinoblastoma Retinitis Pigmentosa Other sight/sound/smell disorder SKIN Acne Albinism Eczema Pigmentation disorders Neurofibromatosis Other disorders of the skin CANCER Breast Ovarian Colon Skin Thyroid cervical Uterine Other GENETIC / CHROMOSOME Down Syndrome Turner Syndrome Fragile Syndrome OTHER You Mother Father Sibling MGM MGF PGM PGF