Family History


Family MemberOccupation

Level of Schooling
Mother
Homemaker

High School
Father
Businessman

B.A.




Family MemberAge if LivingAge at DeathCause of Death
Mother64


Father

65
Heart attack (had high BP and was overweight)
Maternal Grandmother

78
Natural causes/old age
Maternal Grandfather
76
Natural causes/old age
Paternal Grandmother

68
Lung cancer
Paternal Grandfather
70
Natural causes/old age
Sisters
28, 25


Brothers





Test Results
Test Results

Blood Type
O-
HIV 1/2 Abw. Group O
Nonreactive
Chlamydia,by TMA
Negative/Negative
HTLV-1,2 Ab
Nonreactive
Chromosome AnalysisNormal Male 46XY
Neisseria gonorrhea by TMA
Negative
CMV ScreenNegative
ALT
Within normal limits
CMV, IgM/Culture
Not applicable
Sickle cell
Not applicable
Cystic FibrosisNegative for 60 Common Mutations
Syphilis, antibody  (RPR)
Nonreactive
HbsAg
Nonreactive
Tay Sachs & Canavan
Not applicable
HbcAb
Nonreactive
Hepatitis C, Ab
Nonreactive
Thalassemia
Normal adult hemoglobin
HCVRNA/HIV RNA NAT multiplex
Nonreactive/Nonreactive
Notes
HBV DNA NAT multiplex
Nonreactive



Identification #RR384


Pregnancy Proven - Yes
Physical & Personal Characteristics


Date of Birth (Y)
1988
Place of Birth
Louisiana
Height
5'11"
Weight
200
Eye Color
Green
ComplexionMedium
Hair
Brown, Straight
Right Handed     X
Left Handed        
Religion Born IntoCatholic
Married   No

Heritage
French, Irish

Occupation  University Student - Ph.D. candidate

Years of College  10
Interests  Cycling, science, sports, gardening



Notes   Standard (ICI) and Prewashed vials (IUI) vials available 





Donor & Family Health History


Medical ProblemDonor
Family
Heart
None

Father: Heart attack; High blood pressure (overweight)

Blood
NoneNone
Respiratoryseasonal allergies
Paternal Grandmother:  Lung cancer (smoker)
Gastrointestinal
None
None
Metabolic/Endocrine
NoneNone
UrinaryNoneNone
Genital / ReproductiveNone
None
NeurologicalNoneNone
Mental HealthNoneNone
Muscles / Bones / JointsNoneNone
Sight / Sound / SmellNone
None
Skin
None

None


OtherNone

None