Starting build, description, affliction, and first spawn.
When creating a fresh character in the launcher, you are able to set your starting build, write your character's description which can be seen by others, and choose a body affliction if you so choose.
Build lets you apply 4 +10 attribute points to your Magicka, Health, or Stamina. The world is unforgiving and these are an important 40 attribute points.
Description lets you set a current state description of your character which can be seen by others.
Affliction applies any selected disease to your character. You may choose the Sanguinare Vampiris or Lycanthropy and start as a vampire or werewolf, but if you pray at the temple of Riften you will become immune to those afflictions permanently.
After launching, you will spawn in a character creation menu at Winterhold and be able to customize and name your character.
After completion, you will spawn at one of the spawn points with a preliminary set of adventurer's equipment.