Family History


Family MemberOccupation
Level of Schooling
MotherTeacher

M.S.
FatherEngineer

M.S.




Family MemberAge if LivingAge at DeathCause of Death
Mother51


Father57


Maternal Grandmother85


Maternal Grandfather
75
Automobile accident
Paternal Grandmother80


Paternal Grandfather
80
Automobile accident
Sisters


Brothers29


Donor & Family Health History

Medical ProblemDonorFamily
HeartNoneNone
BloodNoneNone
RespiratoryNoneNone
Gastrointestinal
NoneNone
Metabolic/Endocrine
NoneMaternal Grandfather - Diabetes, not insulin dependent
UrinaryNoneNone
Genital / ReproductiveNoneNone
NeurologicalNoneNone
Mental HealthNoneNone
Muscles / Bones / JointsNoneNone
Sight / Sound / SmellNoneNone
SkinAcne as teenager
None
OtherNone
None


Test Results
Test Results
Blood TypeO+
HIV 1/2 Ab & HIV 1 Ag
Nonreactive
ChlamydiaNegative
HTLV-1,2 Ab
Nonreactive
Chromosome AnalysisNormal Male 46XY
Neisseria gonorrhea
Negative
CMV ScreenPositive
SGPT
Within normal limits
CMV, IgM/Culture
Negative
Sickle cell
Not applicable
Cystic FibrosisNoncarrier of 51 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 #RR365


Pregnancy Proven - Yes
Physical & Personal Characteristics


Date of Birth (Y)1980
Place of BirthIndia
Height6'0"
Weight194
Eye Color
Brown
Complexion
 Fair - Asian
HairBlack, straightRight Handed      X
Left Handed
Religion Born IntoHindu
Married   No
HeritageIndian

Occupation Graduate Student in Civil Engineering

Years of College  6
Interests Reading, books, puzzles, soccer and cricket



Notes Standard (ICI) vials available. Limited supply.