Donor Abstract 

IDENTIFICATION NO. RR350 DATE 11/02

 PHYSICAL AND PERSONAL CHARACTERISTICS
DOB (M/Y) 02/1972 PLACE OF BIRTH  Louisiana
HEIGHT 5'10" WEIGHT 200
EYE COLOR  Green COMPLEXION Fair
HAIR Strawberry Blonde, Straight AMBIDEXTROUS  X LEFT HANDED
RELIGION BORN INTO Roman Catholic MARRIED No NO. OF CHILDREN 0
YRS OF COLLEGE 8 OCCUPATION Graduate Student, Teacher and Coach HERITAGE French,  Irish
INTEREST Sports

 TEST RESULTS
Blood Type  O Negative 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  HIV-1/HCV RNA  Nonreactive

 DONOR AND FAMILY HEALTH HISTORY
MEDICAL PROBLEM DONOR RELATIVE

HEART

None

 Paternal Grandfather- Heart Attack -  Father - High Blood Pressure

BLOOD

 None None
RESPIRATORY None None
GASTROINTESTINAL None None
METABOLIC/ENDOCRINE None Father - became diabetic in his 50's/diet controlled
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 None

 FAMILY HISTORY
LEVEL OF SCHOOLING: Mother High School Father High School
OCCUPATION: Mother Secretary Father Surveyor
 
  AGE IF LIVING AGE AT DEATH CAUSE OF DEATH
MOTHER 51    
FATHER 59    
MATERNAL GRANDFATHER   71 Not Known
MATERNAL GRANDMOTHER 83    
PATERNAL GRANDFATHER   59 Heart Disease
PATERNAL GRANDMOTHER 88     
BROTHERS 27    
SISTERS 31     

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