Donor Abstract
| IDENTIFICATION NO. RR351 | DATE 11/02 | ||||
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PHYSICAL AND PERSONAL CHARACTERISTICS |
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| DOB (M/Y) 07/1983 | PLACE OF BIRTH Mississippi | ||||
| HEIGHT 5'10" | WEIGHT 180 | ||||
| EYE COLOR Blue | COMPLEXION Fair | ||||
| HAIR Light Brown, Curly | RIGHT HANDED X | LEFT HANDED | |||
| RELIGION BORN INTO Roman Catholic | MARRIED No | NO. OF CHILDREN 0 | |||
| YRS OF COLLEGE 2 | OCCUPATION Computer Systems and Spanish Major | HERITAGE German | |||
| INTEREST Weight lifting, running | |||||
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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 Negative IgM and culture | 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 | ||||
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DONOR AND FAMILY HEALTH HISTORY |
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| MEDICAL PROBLEM | DONOR | RELATIVE | |||
| HEART |
None |
None | |||
|
BLOOD |
None | None | |||
| RESPIRATORY | None | Grandfather - hay fever | |||
| 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 | Paternal Grandfather - alcoholism | |||
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FAMILY HISTORY |
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| LEVEL OF SCHOOLING: | Mother BS | Father BS | |||
| OCCUPATION: | Mother Nurse-Drug Representative | Father Owns his own business | |||
| AGE IF LIVING | AGE AT DEATH | CAUSE OF DEATH | |||
| MOTHER | 48 | ||||
| FATHER | 52 | ||||
| MATERNAL GRANDFATHER | 67 | ||||
| MATERNAL GRANDMOTHER | 68 | ||||
| PATERNAL GRANDFATHER | 50 | Cirrhoses of Liver & Heart problems due to alcoholism | |||
| PATERNAL GRANDMOTHER | 68 | ||||
| BROTHERS | 22 | ||||
| SISTERS | None | ||||