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# Egg Donor Application Form
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Name: Kristina
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Date of Birth: April 28, 2002
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Age: 23
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Nationality: Kazakhstan
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Ethnicity: Russian
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Place of Residence: Ekibastuz, Kazakhstan
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Height: 164 cm
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Weight: 66 kg
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Blood Type: B Rh Positive
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Education Level: Secondary
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Occupation: Accountant and Economist
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Body Type: Average
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Marital Status: Divorced
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Number of Children: 1
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### Medical Information
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Last Delivery Date: September 23, 2020
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Last Menstrual Period: May 12 (assumed to be 2025 based on context)
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Surgeries: None
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C-section: No
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Number of C-sections: 0
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Last Pregnancy and Delivery Date: September 23, 2020
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### Physical Features
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Hair Texture: Medium density, medium length
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Hair Color: Dark chestnut
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Eye Color: Brown
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### Additional Information
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Do you smoke? No
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Do you drink alcohol? No
