Test Results
Test Results
Blood TypeO-
HIV 1/2 Ab; HIV 1 Ag
Nonreactive/Nonreactive
ChlamydiaNegative
HTLV-1,2 Ab
Nonreactive
Chromosome AnalysisNormal Male 46XY
Neisseria gonorrhea
Negative
CMV ScreenNegative
SGPT
Within normal limits
CMV, IgM/Culture
Not applicable
Sickle cell
Not applicable
Cystic FibrosisNegative for 37 Common Mutations
Syphilis, antibody  MHA-TP
Nonreactive
HbsAg
Nonreactive
Tay Sachs & Canavan
Not applicable
HbcAb
Nonreactive
Hepatitis C, Ab
Nonreactive
Thalassemia
Normal adult hemoglobin
HCVRNA/HIV-1 RNA
Nonreactive/Nonreactive
Notes


Identification #RR350


Pregnancy Proven - Yes
Physical & Personal Characteristics


Date of Birth (Y)1972
Place of BirthLouisiana
Height5'10"
Weight200
Eye Color
Green
ComplexionFair
HairStrawberry Blonde, Straight
Right Handed     X  
Left Handed         X
Religion Born IntoRoman Catholic
Married   No
Heritage
French, Irish

Occupation  Graduate Student and Coach

Years of College  8
Interests  Sports



Notes  PW (IUI) vials only



Family History


Family MemberOccupation
Level of Schooling
Mother
Secretary

High School
FatherSurveyor

High School




Family MemberAge if LivingAge at DeathCause of Death
Mother51


Father59


Maternal Grandmother83


Maternal Grandfather
71
Unknown
Paternal Grandmother88


Paternal Grandfather
59
Heart Disease
Sisters31


Brothers27


Donor & Family Health History

Medical ProblemDonorFamily
HeartNone

Father: High blood pressure

Paternal Grandfather:  Heart Attack

Blood
NoneNone
RespiratoryNone
None
Gastrointestinal
NoneNone
Metabolic/Endocrine
NoneFather:  Became diabetic in his 50s/controlled with diet
UrinaryNoneNone
Genital / ReproductiveNoneNone
NeurologicalNoneNone
Mental HealthNoneNone
Muscles / Bones / JointsNoneNone
Sight / Sound / SmellNone
None
Skin
None
None
OtherNoneNone