Donor Abstract
| IDENTIFICATION NO. RR364 | DATE 04/2004 | ||||
PHYSICAL AND PERSONAL CHARACTERISTICS |
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| DOB (M/Y) 10/1978 | PLACE OF BIRTH India | ||||
| HEIGHT 5'11" | WEIGHT 160 | ||||
| EYE COLOR Brown | COMPLEXION Medium, Asian | ||||
| HAIR Black, Straight | RIGHT HANDED X | LEFT HANDED | |||
| RELIGION BORN INTO Hindu | MARRIED No | NO. OF CHILDREN none | |||
| YRS OF COLLEGE 7 - MS +1 year | OCCUPATION Engineering | HERITAGE Indian | |||
| INTERESTS Tennis and jogging | |||||
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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 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 | ||||
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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 | 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 | Acne-Mother and Brother | |||
| OTHER | None | None | |||
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FAMILY HISTORY |
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| LEVEL OF SCHOOLING: | Mother High School | Father High School | |||
| OCCUPATION: | Mother Homemaker | Father Small Business Owner | |||
| AGE IF LIVING | AGE AT DEATH | CAUSE OF DEATH | |||
| MOTHER | 50 | ||||
| FATHER | 55 | ||||
| MATERNAL GRANDFATHER | 75 | ||||
| MATERNAL GRANDMOTHER | 70 | ||||
| PATERNAL GRANDFATHER | 55 | Accident | |||
| PATERNAL GRANDMOTHER | 80 | Old Age | |||
| BROTHERS | 21 | ||||
| SISTERS | |||||