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EXPANDED PROFILE : Amber664

EXPANDED PROFILE : Amber664eggdonationsouthafrica.co.za/donors/catalog/view/dp/A664_expande… · Complexion: Medium Tan Ability: None / Slight / Medium / Easy Cheek Bones: High

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Page 1: EXPANDED PROFILE : Amber664eggdonationsouthafrica.co.za/donors/catalog/view/dp/A664_expande… · Complexion: Medium Tan Ability: None / Slight / Medium / Easy Cheek Bones: High

EXPANDED PROFILE : Amber664

Page 2: EXPANDED PROFILE : Amber664eggdonationsouthafrica.co.za/donors/catalog/view/dp/A664_expande… · Complexion: Medium Tan Ability: None / Slight / Medium / Easy Cheek Bones: High

SOME INTERESTING FACTS ABOUT: Amber664 YOUR STAR SIGN: Aries WHAT DO YOU CONSIDER AS YOUR BEST FACIAL FEATURE: Eyes, Mouth WHAT DO YOU CONSIDER TO BE YOUR BEST PHYSICAL FEATURE: My Structure HOW WOULD YOU DESCRIBE YOUR SMILE: Loving HOW WOULD YOU DESCRIBE YOUR LAUGH: I just laughing out loud WHICH ACTRESS OR FAMOUS PERSON YOU THINK YOU RESEMBLE: Andisiwe

Dweba

FAVOURITES FOOD/S: Chicken BOOK/S: Magazines & newspapers MOVIE/S: “Chick Flicks” SONG/S: R&B, Gospel DO YOU PLAY A MUSICAL INSTRUMENT? No FAVOURITE MUSICAL INSTRUMENT: Piano ACTOR/ESS: Denzel Washington COLOUR: Red, Black CAR: Mini Cooper FLOWER: Rose GEM STONE: Aquamarine ANIMAL: Dog TIME OF DAY: Morning SEASON: Summer DESTINATION: America HISTORICAL FIGURE: Robert Sobukwe PERSON YOU WOULD MOST LIKE TO MEET: Oliver Tambo WHY? I was so inspired by him, and his sacrifices for other

people. FAVOURITE SUBJECT @ SCHOOL: Economics ANY SPECIAL AWARDS/ACHIEVEMENTS: SRC member, Certificate for best Xhosa student FAVOURITE QUOTE: “Always put yourself in someone else’s shoes”

PERSONAL PREFERENCES/ABILITIES ARE YOU SKILLED: MECHANICALLY / TECHNICALLY HOW WOULD YOU RATE YOUR ABILITY IN MATH: POOR / AVERAGE / GOOD LITERARY SKILLS: POOR / AVERAGE / GOOD SCIENTIFIC/ RESEARCH ABILITIES: POOR / AVERAGE / GOOD ARTICTIC TALENTS: POOR / AVERAGE / GOOD MUSIC SKILLS / ABILITIES: POOR / AVERAGE / GOOD ATHLETIC ABILITIES: POOR / AVERAGE / GOOD HOW MANY LANGUAGES CAN YOU SPEAK? 2: English and Xhosa

Page 3: EXPANDED PROFILE : Amber664eggdonationsouthafrica.co.za/donors/catalog/view/dp/A664_expande… · Complexion: Medium Tan Ability: None / Slight / Medium / Easy Cheek Bones: High

SPECIAL SKILLS & PERSONALITY OF FAMILY MEMBERS Music / Artistic / Athletic / Scientific / Math skills / Personality / Employment / Hobbies / Other interesting facts

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

MOTHER: My mother works at a hospital. She loves caring for people and saving lives. Every time she gets paid she takes us out and buys us new clothes. My mom loves to go to church and takes us with her every Sunday. FATHER: My father used to spoil me rotten☺. I look just like him. He worked on a farm and treated us to lots of fruit. BROTHER 1: He looks after me and my child. He likes painting and playing nice music. BROTHER 2: My brother has taken up the role of disciplinarian in our family. He keep a tight reign on all of us, but we know that he loves us, and has a soft heart☺ he is always the first to apologise and loves watching movies with the family. BROTHER 3: He is a manager at a fast food outlet. He is very good looking, girls love him☺ SISTER: My sister is married and stays far from us. Every time she comes home it feels like Christmas. She cooks and brings us lots of gifts. SISTER 2: My sister and I are close because we are nearly the same age. She is a great listener and gives us all amazing advice. She is very pretty, like me☺ SISTER 3: My sister passed away. Unfortunately we were not very close. Children: I just love my little girl and when she smiles, everything is alright. She loves food. When her bottle is finished, she cries as if she has been hit by a bus☺

Page 4: EXPANDED PROFILE : Amber664eggdonationsouthafrica.co.za/donors/catalog/view/dp/A664_expande… · Complexion: Medium Tan Ability: None / Slight / Medium / Easy Cheek Bones: High

FACIAL CHARACTERISTICS

Eye Shape: Hooded / Down Turned / Almond / Round / Protruding

Eye Set: Narrow / Close / Average / Deep/ Wide Eye Size: Small / Average / Large Eye colour: Dark Brown 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: Black Premature Graying: Yes / No, If yes, at what age: - Present hair loss: None / Thinning Complexion: Medium 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: The Rectangle Height: 1.64m

Weight: 75.0kg

BMI: 27.9

Build: Petite/Small/Medium/Athletic/Large/Stocky

Hands: Right-handed/Left-handed/Ambidextrous

Face Shape: Round

Page 5: EXPANDED PROFILE : Amber664eggdonationsouthafrica.co.za/donors/catalog/view/dp/A664_expande… · Complexion: Medium Tan Ability: None / Slight / Medium / Easy Cheek Bones: High

MEDICAL PROFILE

PERSONAL HEALTH HISTORY Blood Group (ABO): N/A Rhesus: N/A 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: - Hearing (without corrective aids): Poor / Fair / Good / Excellent Do you wear corrective aids? No If yes, for what problems? N/A Do you smoke cigarettes? No If yes, how many per day? N/A Do you drink alcohol? No If yes, how often? N/A Diet: Vegetarian / Non vegetarian / Other: Allergies: None 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: - Reaction(s): - Age: - Explain allergies you have outgrown: - Exercise/ Sporting activities: None / Occasional / Regular Type of Exercise: Running Have you had any surgery (ies)? No If yes please explain: N/A Have you had any hospitalisation(s) not mentioned above? - 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:

Page 6: EXPANDED PROFILE : Amber664eggdonationsouthafrica.co.za/donors/catalog/view/dp/A664_expande… · Complexion: Medium Tan Ability: None / Slight / Medium / Easy Cheek Bones: High

Have you ever been tested as a carrier of?

Carrier Non-carrier Unknown Tay-Sach’s disease X Sickle Cell disease X Thalassemia X Cystic Fibrosis x

FERTILITY HISTORY

AMH: Not tested AFC: Not Measured Have you ever been pregnant? Yes Do you have any children? Yes If yes, please complete below:

Sex: Female Year of birth: 2015 Health Status: Excellent

Any special comments concerning your children? No 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.

If you would like more information on this donor’s assessment; we will put you in touch with the psychologist

responsible for the donor’s evaluation.

The clinic may require you to sign consent before you proceed with the donor.

Page 7: EXPANDED PROFILE : Amber664eggdonationsouthafrica.co.za/donors/catalog/view/dp/A664_expande… · Complexion: Medium Tan Ability: None / Slight / Medium / Easy Cheek Bones: High

SEXUAL 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 FAMILY HEALTH HISTORY (Natural eye & hair colour; fair/light/medium/dark complexion; small/medium/large frame/build)

Eye

Col

our

Hai

r C

olou

r

Com

plex

ion

Hei

ght

Wei

ght

Bui

ld

Mother Brown Black Medium - - Medium

Father Brown Black Light - - Medium

Brother 1 Brother 2 Brother 3

Brown Black Brown

Black Black Black

Light Dark Light

- - Medium Medium Medium

Sister 1 Sister 2 Sister 3

Brown Brown Brown

Black Black Black

Medium Medium Medium

- - Small Medium Medium

Child Brown Black Light - - Medium

MGM Brown Black Medium - - Medium

MGF Brown Black Medium - - Medium

PGM Brown Black Light - - Medium

PGF Brown Black Light - - Medium

(MGM = Maternal Grandmother, MGF = Maternal Grandfather, PGM = Paternal Grandmother, PGF = Paternal Grandfather, - = Unknown)

Page 8: EXPANDED PROFILE : Amber664eggdonationsouthafrica.co.za/donors/catalog/view/dp/A664_expande… · Complexion: Medium Tan Ability: None / Slight / Medium / Easy Cheek Bones: High

How many blood siblings are in your immediate family (including yourself)? 7 Number of Males: 3 Number of Females: 4 How many half siblings are in your immediate family? 0 If so, from which parent? N/A Number of Males: N/A Number of Females: N/A How many adopted siblings are in your immediate family (including yourself)? N/A Number of Males: N/A Number of Females: N/A Are there any twins or triplets in your family? No If yes, what relations are they to you? N/A Are there any known genetic diseases or conditions that run in your family? No If yes, please identify: N/A Have you or any family members described above had genetic counseling? No If yes, please describe: N/A Are there any members of your family with a history of learning disabilities? No If yes, please explain: N/A List below the ages of the following biological members of your family; if they are deceased, please list cause of death. Year of Birth Age at time of death Cause of death

Mother 1945 - - Father 1924 86 Natural Causes

Brother 1 1970 - - Brother 2 1975 - - Brother 3 1982 - - Sister 1 1973 38 Car Accident Sister 2 1984 - - Sister 3 1988 - -

MGM - Unknown Unknown MGF - Unknown Unknown PGM - Unknown Unknown PGF - Unknown Unknown

Page 9: EXPANDED PROFILE : Amber664eggdonationsouthafrica.co.za/donors/catalog/view/dp/A664_expande… · Complexion: Medium Tan Ability: None / Slight / Medium / Easy Cheek Bones: High

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 X 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) X Thyroid disease Goiter Hyperactivity Phenyl Ketonuria (PKU) Cystic fibrosis Dwarfism Lupus/other auto immune diseases URINARY Kidney disease Other disease/defect of urinary tract

My father was diagnosed with Diabetes at age 50. It was well controlled with tablets. My mother was diagnosed with High Blood Pressure at age 55. It is well controlled with tablets.

Page 10: EXPANDED PROFILE : Amber664eggdonationsouthafrica.co.za/donors/catalog/view/dp/A664_expande… · Complexion: Medium Tan Ability: None / Slight / Medium / Easy Cheek Bones: High

You Mother Father Sibling MGM MGF PGM PGF 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 X 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 X Syndrome OTHER

My brother took my sister’s passing very badly. He took medication for 6 months for Depression.