As stated in the rules, you can add anything to this, but please include the following information:

[b]Name:[/b] (Your character's name)
[b]Race:[/b] (your character's race)
[b]Date of birth:[/b] (your character's date of birth; the year is sufficient)
[b]Witch/wizard:[/b] (Yes/no)
[b]Gene:[/b] (Yes/no; only applies if the character is a witch/wizard)