Donor Abstract
| IDENTIFICATION NO. RR349 | DATE 11/02 | ||||
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PHYSICAL AND PERSONAL CHARACTERISTICS |
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| DOB (M/Y) 07/1976 | PLACE OF BIRTH New Orleans | ||||
| HEIGHT 6'4" | WEIGHT 175 | ||||
| EYE COLOR Hazel | COMPLEXION Medium | ||||
| HAIR Dark Brown, Wavy | RIGHT HANDED X | LEFT HANDED | |||
| RELIGION BORN INTO Roman Catholic | MARRIED No | NO. OF CHILDREN 0 | |||
| YRS OF COLLEGE 3 | OCCUPATION English Major | HERITAGE French, Spanish, Italian | |||
| INTEREST Music, Photography | |||||
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TEST RESULTS
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| Blood Type A 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 |
Paternal Grandfather- Stroke, Father - High Blood Pressure | |||
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BLOOD |
None | None | |||
| RESPIRATORY | None | Cousin - Asthma | |||
| 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 | Father - Gout | |||
| 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 High School | Father 1 Year of College | |||
| OCCUPATION: | Mother Homemaker | Father Independent Insurance Broker | |||
| AGE IF LIVING | AGE AT DEATH | CAUSE OF DEATH | |||
| MOTHER | 53 | ||||
| FATHER | 53 | ||||
| MATERNAL GRANDFATHER | 70's | ||||
| MATERNAL GRANDMOTHER | 70's | ||||
| PATERNAL GRANDFATHER | 74 | Stroke | |||
| PATERNAL GRANDMOTHER | 40's | Child birth | |||
| BROTHERS | 30, 22, 14 | ||||
| SISTERS | None | ||||