Family History


Family MemberOccupation
Level of Schooling
Mother
Business Owner

High School
FatherBusiness Owner

High School




Family MemberAge if LivingAge at DeathCause of Death
Mother56


Father59


Maternal Grandmother
65
Heart Failure
Maternal Grandfather80


Paternal Grandmother
76
Old Age
Paternal Grandfather
78
Respiratory Complications
Sisters33


Brothers29


Donor & Family Health History

Medical ProblemDonorFamily
HeartNone

Father: High Blood Pressure

Grandfather:  Stroke

BloodNoneNone
RespiratoryHayfever as a child
Sibling:  Asthma
Gastrointestinal
NoneNone
Metabolic/Endocrine
NoneFather:  Diabetes at age 45
UrinaryNoneNone
Genital / ReproductiveNoneNone
NeurologicalNoneNone
Mental HealthNoneNone
Muscles / Bones / JointsNoneNone
Sight / Sound / SmellDeviated septum; nearsighted
None
SkinNone
None
OtherNoneNone


Test Results
Test Results
Blood TypeO+
HIV 1/2 Ab; HIV 1 Ag
Nonreactive/Nonreactive
ChlamydiaNegative by PCR
HTLV-1,2 Ab
Nonreactive
Chromosome AnalysisNormal Male 46XY
Neisseria gonorrhea
No growth
CMV ScreenNegative
SGPT
Within normal limits
CMV, IgM/Culture
Not Applicable
Sickle cell
Not applicable
Cystic FibrosisNegative for 33 Common Mutations
Syphilis, antibody
Nonreactive
HbsAg
Nonreactive
Tay Sachs & Canavan
Noncarrier for common mutations
HbcAb
Nonreactive
Hepatitis C, Ab
Nonreactive
Thalassemia
Normal adult hemoglobin
HCVRNA/HIV-1 RNA
Not done prior to 2004
Notes


Identification #RR307


Pregnancy Proven - Yes
Physical & Personal Characteristics


Date of Birth (Y)1963
Place of BirthNew York
Height5'8"
Weight133
Eye ColorHazel
ComplexionMedium
HairDark Brown, Straight
Right Handed     X
Left Handed
Religion Born IntoJudaism
Married   No
HeritagePolish, Austro-Hungarian

Occupation Graduate Student in Linguistics, Educator

Years of College  6
Interests Travel, Languages, Music, Art



Notes Standard (ICI) vials available.