Donor Abstract 

IDENTIFICATION NO. RR341 DATE 11/02

 PHYSICAL AND PERSONAL CHARACTERISTICS
DOB (M/Y) 04/1971 PLACE OF BIRTH  Mississippi
HEIGHT 5'9" WEIGHT 170
EYE COLOR  Hazel COMPLEXION Medium
HAIR Brown, Wavy RIGHT HANDED  X LEFT HANDED
RELIGION BORN INTO Methodist MARRIED Yes NO. OF CHILDREN 1
YRS OF COLLEGE 6 OCCUPATION Law Student HERITAGE English, Irish, French
INTERESTS Running, Reading, All Sports

 TEST RESULTS
Blood Type O Positive HIV 1/2 Ab. & HIV 1 Ag.  Nonreactive
Chlamydia Negative  HTLV-1,2 Ab. Nonreactive
Chromosome analysis 46, XY Neisseria gonorrhea Negative
CMV, IgG Negative SGPT Normal
Cystic Fibrosis 37 Common Mutations - Negative Sickle cell Not Applicable
Group B streptococcus  Negative Syphilis, antibody Nonreactive
HbsAg & HbcAb Nonreactive Tay Sachs & Canavan Not Tested
Hepatitis C, Ab Nonreactive Thalassemia Normal Adult Hemoglobin
Trichomonas & yeast Not Present  

 

DONOR AND FAMILY HEALTH HISTORY

 
MEDICAL PROBLEM DONOR RELATIVE

HEART

None

 85 year old grandmother has hypertension which started in old age

BLOOD

 None None
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 None
SIGHT/SOUND/SMELL None None
SKIN None None
OTHER None Mother died of aneurysm at 47 years of age

 

 FAMILY HISTORY

 
LEVEL OF SCHOOLING: Mother Master Degree Father Bachelor's Degree
OCCUPATION: Mother Research Librarian Father Police Officer
 
  AGE IF LIVING AGE AT DEATH CAUSE OF DEATH
MOTHER 47 Aneurysm
FATHER 52
MATERNAL GRANDFATHER Not Known
MATERNAL GRANDMOTHER 90 Old Age
PATERNAL GRANDFATHER 87
PATERNAL GRANDMOTHER 85
BROTHERS None    
SISTERS None    

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