Donor Abstract
| IDENTIFICATION NO. RR346 | DATE 11/02 | ||||
|
PHYSICAL AND PERSONAL CHARACTERISTICS |
|||||
| DOB (M/Y) 08/1977 | PLACE OF BIRTH Tennessee | ||||
| HEIGHT 5'7" | WEIGHT 135 | ||||
| EYE COLOR Blue | COMPLEXION Fair | ||||
| HAIR Brown, Curly | RIGHT HANDED X | LEFT HANDED | |||
| RELIGION BORN INTO Protestant | MARRIED No | NO. OF CHILDREN none | |||
| YRS OF COLLEGE 3 | OCCUPATION Political Science Major Student | HERITAGE Swedish, German, English | |||
| INTERESTS Athletics, Chess, Film Making | |||||
|
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 | CMV, IgM Not applicable | ||||
| 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 | SGPT Normal | ||||
|
DONOR AND FAMILY HEALTH HISTORY
|
|||||
| MEDICAL PROBLEM | DONOR | RELATIVE | |||
| HEART |
None |
Maternal grandfather- high blood pressure, heart disease and heart attack. Paternal grandfather-heart disease | |||
|
BLOOD |
None | None | |||
| RESPIRATORY | None | None | |||
| GASTROINTESTINAL | None | Father - colitis | |||
| METABOLIC/ENDOCRINE | None | Sister - recovered from thyroid cancer | |||
| URINARY | None | None | |||
| GENITAL/REPRODUCTIVE SYSTEM | None | None | |||
| NEUROLOGICAL | None | None | |||
| MENTAL HEALTH | None | None | |||
| MUSCLES/BONES/JOINTS | None | Maternal grandmother - arthritis | |||
| SIGHT/SOUND/SMELL | None | None | |||
| SKIN | None | None | |||
| OTHER | None | None | |||
|
FAMILY HISTORY
|
|||||
| LEVEL OF SCHOOLING: | Mother MA | Father Ph.D. | |||
| OCCUPATION: | Mother Homemaker | Father Professor | |||
| AGE IF LIVING | AGE AT DEATH | CAUSE OF DEATH | |||
| MOTHER | 52 | ||||
| FATHER | 53 | ||||
| MATERNAL GRANDFATHER | 73 | Heart Disease | |||
| MATERNAL GRANDMOTHER | 74 | ||||
| PATERNAL GRANDFATHER | 71 | Heart Disease | |||
| PATERNAL GRANDMOTHER | 75 | ||||
| BROTHERS | None | ||||
| SISTERS | 27 | ||||