Donor Abstract
| IDENTIFICATION NO. RR170 | ORIGINAL DATE 5/91 UPDATED 10/99 | ||||
PHYSICAL AND PERSONAL CHARACTERISTICS |
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| DOB (M/Y) 05/1970 | PLACE OF BIRTH Pennsylvania | ||||
| HEIGHT 5'8" | WEIGHT 145 | ||||
| EYE COLOR Brown | COMPLEXION Fair | ||||
| HAIR Dark Brown, Wavy | RIGHT HANDED X | LEFT HANDED | |||
| RELIGION BORN INTO Judaism | MARRIED No | NO. OF CHILDREN none | |||
| YRS OF COLLEGE 4 | OCCUPATION Business Degree | HERITAGE Russian | |||
| INTERESTS history, sports, political science, business | |||||
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TEST RESULTS |
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| Blood Type AB Positive | HIV, Ab. & Ag. Nonreactive | ||||
| Chlamydia Swab Nonreactive | HTLV-1, Ab. Nonreactive | ||||
| CMV, IgG Nonreactive | Neisseria gonorrhea No Growth | ||||
| Cystic fibrosis
Noncarrier of common deletions |
SGPT Normal | ||||
| Group B streptococcus No Growth | Sickle cell Not Applicable | ||||
| HbsAg & HbcAb Nonreactive | Syphilis, antibody Nonreactive | ||||
| Hepatitis C, Ab Nonreactive | Tay Sachs Noncarrier | ||||
| Trichomonas & yeast None Seen | |||||
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DONOR AND FAMILY HEALTH HISTORY |
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| MEDICAL PROBLEM | DONOR | RELATIVE | |||
| HEART |
None |
Father: heart attack in mid 70's | |||
BLOOD |
None | Cousin: Leukemia | |||
| RESPIRATORY | None | None | |||
| GASTROINTESTINAL | None | None | |||
| METABOLIC/ENDOCRINE | None | None | |||
| URINARY | None | None | |||
| GENITAL/REPRODUCTIVE SYSTEM | None | None | |||
| NEUROLOGICAL | None | None | |||
| MENTAL HEALTH | None | None | |||
| MUSCLES/BONES/JOINTS | None | Grandfather: Lou Gehrig's Disease | |||
| SIGHT/SOUND/SMELL | None | None | |||
| SKIN | None | Grandmother: skin cancer in mid 70's | |||
| OTHER | None | None | |||
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FAMILY HISTORY |
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| LEVEL OF SCHOOLING: | Mother B.S. Degree | Father M.D. Degree | |||
| OCCUPATION: | Mother Teacher/Homemaker | Father
Private Practice Physician |
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| AGE IF LIVING | AGE AT DEATH | CAUSE OF DEATH | |||
| MOTHER | 46 | ||||
| FATHER | 49 | ||||
| MATERNAL GRANDFATHER | 75 | Heart Attack | |||
| MATERNAL GRANDMOTHER | 81 | ||||
| PATERNAL GRANDFATHER | 65 | Lou Gehrig's Disease | |||
| PATERNAL GRANDMOTHER | 78 | ||||
| BROTHERS | |||||
| SISTERS | 17 | ||||