Donor Abstract

IDENTIFICATION NO. RR363 DATE 04/2004

 PHYSICAL AND PERSONAL CHARACTERISTICS

DOB (M/Y) 10/1979 PLACE OF BIRTH  India
HEIGHT 6'2" WEIGHT 170
EYE COLOR  Brown COMPLEXION Fair-Medium, Asian
HAIR Black, Wavy RIGHT HANDED  X LEFT HANDED
RELIGION BORN INTO Hindu MARRIED No NO. OF CHILDREN none
YRS OF COLLEGE 5 OCCUPATION  Engineering HERITAGE Indian
INTERESTS sports and movies

 TEST RESULTS

Blood Type A Positive HIV 1/2 Ab. & HIV 1 Ag.  Nonreactive
Chlamydia Negative HTLV-1 Ab Nonreactive
Chromosome analysis Normal male 46XY Neisseria gonorrhea Negative
Cystic Fibrosis Non carrier for 51 common mutations SGPT Within normal limits
CMV, IgM Nonreactive Sickle cell Not applicable
CMV culture No growth Syphilis, antibody Nonreactive
HbsAg & HbcAb Nonreactive Tay Sachs Not applicable
Hepatitis C, Ab Nonreactive Thalassemia Normal adult hemoglobin
Trichomonas & yeast None seen  HIV-1/HCV RNA  Nonreactive

 DONOR AND FAMILY HEALTH HISTORY

MEDICAL PROBLEM DONOR RELATIVE

HEART

None

Paternal grandfather: high blood pressure and heart attack

BLOOD

None None
RESPIRATORY None None
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 None

 FAMILY HISTORY

LEVEL OF SCHOOLING: Mother High School Father BS
OCCUPATION: Mother Homemaker Father Accountant
 
  AGE IF LIVING AGE AT DEATH CAUSE OF DEATH
MOTHER 43    
FATHER 52    
MATERNAL GRANDFATHER   30's Car accident
MATERNAL GRANDMOTHER   30's Car accident
PATERNAL GRANDFATHER   73 Heart Attack
PATERNAL GRANDMOTHER   65  Unknown
BROTHERS 22    
SISTERS      

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