Family History


Family MemberOccupation
Level of Schooling
MotherSecretary

Some College
FatherSmall Business Owner

High School




Family MemberAge if LivingAge at DeathCause of Death
Mother
65
Lung cancer
Father
52
Stroke
Maternal Grandmother
89
Old Age
Maternal Grandfather
40's
War Casualty WWII
Paternal Grandmother93


Paternal Grandfather
60
Stroke
Sisters


Brothers
43 and 46


Donor & Family Health History

Medical ProblemDonorFamily
HeartNone

Father:  High Blood Pressure and stroke @ age 52 (smoker, overweight)

Grandfather - stroke at age 60, heart disease


BloodNoneNone
RespiratoryNoneMother:  Lung cancer (smoker)
Gastrointestinal
NoneNone
Metabolic/Endocrine
NoneMother:  Diabetes at age 50
UrinaryNoneNone
Genital / ReproductiveNoneNone
NeurologicalNoneNone
Mental HealthNoneNone
Muscles / Bones / JointsNoneElderly grandmother:  gout
Sight / Sound / Smell
NoneNone
SkinNoneBrother:  acne as a teenager
OtherNoneNone


Test Results
Test Results
Blood TypeA-
HIV 1/2 Ab &HIV 1 Ag
Nonreactive
ChlamydiaNonreactive
HTLV-1,2 Ab
Nonreactive
Chromosome AnalysisNormal Male 46XY
Neisseria gonorrhea
No growth
CMV ScreenPositive
SGPT
Normal
CMV, IgM/Culture
Nonreactive/No growth
Sickle cell
Not applicable
Cystic FibrosisNoncarrier of 33 Common Mutations
Syphilis, antibody
Nonreactive
HbsAg
Nonreactive
Tay Sachs & Canavan
Not applicable
HbcAb
Nonreactive
Hepatitis C, Ab
Nonreactive
Thalassemia
Normal adult hemoglobin
HCVRNA/HIV-1 RNA
Not done prior to 2004
Notes


Identification #RR097


Pregnancy Proven - Yes
Physical & Personal Characteristics



Date of Birth (Y)1967
Place of Birth
Ohio
Height
6'1"
Weight200
Eye Color
Blue
ComplexionFair
HairLt. brown, wavy
Right Handed     X
Left Handed
Religion Born Into
Catholicism
Married   Yes

HeritagePolish, German

Occupation College Professor

Years of College  8
Interests  Family, soccer, basketball, scuba



Notes Standard and Prewashed vials available.