Donor Abstract
| IDENTIFICATION NO. RR342 | DATE 11/02 | ||||
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PHYSICAL AND PERSONAL CHARACTERISTICS |
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| DOB (M/Y) 04/1973 | PLACE OF BIRTH California | ||||
| HEIGHT 6'2" | WEIGHT 200 | ||||
| EYE COLOR Blue | COMPLEXION Fair-Medium | ||||
| HAIR Brown, Straight | RIGHT HANDED X | LEFT HANDED | |||
| RELIGION BORN INTO Roman Catholic | MARRIED No | NO. OF CHILDREN none | |||
| YRS OF COLLEGE 8 | OCCUPATION Medical Intern | HERITAGE Irish, German | |||
| INTERESTS Golf, travel | |||||
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TEST RESULTS |
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| 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 | |||||
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DONOR AND FAMILY HEALTH HISTORY
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| MEDICAL PROBLEM | DONOR | RELATIVE | |||
| HEART |
None |
Maternal Grandfather died of stroke at age 67; Father mild hypertension | |||
|
BLOOD |
None | None | |||
| RESPIRATORY | None | None | |||
| GASTROINTESTINAL | Hepatitis A | None | |||
| METABOLIC/ENDOCRINE | None | None | |||
| URINARY | None | None | |||
| GENITAL/REPRODUCTIVE SYSTEM | None | None | |||
| NEUROLOGICAL | None | Maternal grandmother had Alzheimer's | |||
| MENTAL HEALTH | None | None | |||
| MUSCLES/BONES/JOINTS | None | None | |||
| SIGHT/SOUND/SMELL | None | None | |||
| SKIN | None | None | |||
| OTHER | None | None | |||
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FAMILY HISTORY
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| LEVEL OF SCHOOLING: | Mother 4 | Father MBA | |||
| OCCUPATION: | Mother Events Coordinator | Father Consultant | |||
| AGE IF LIVING | AGE AT DEATH | CAUSE OF DEATH | |||
| MOTHER | 59 | ||||
| FATHER | 63 | ||||
| MATERNAL GRANDFATHER | 67 | Stroke | |||
| MATERNAL GRANDMOTHER | 75 | Alzheimer's | |||
| PATERNAL GRANDFATHER | 65 | Prostate cancer | |||
| PATERNAL GRANDMOTHER | 60 | Suicide | |||
| BROTHERS | 27 | ||||
| SISTERS | 31 | ||||