Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
6'0"
(182 cm) |
Weight:
176 lb
(79 kg) |
Eye Color:
Green
|
Hair:
Brown/
Straight |
Skin Tone:
Medium
|
Ancestry:
Caucasian
|
|
Blood Type:
O+
|
Ethnic Background:
German-Irish/English-Welsh
|
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|
Education:
Doctorate of Medicine
|
Occupation:
Physician
|
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|
Interests:
|
Music, Sports, Travel
|
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Medical
| Question | Response |
| Have you or any of your family members been diagnosed with alcoholism or drug addiction? If yes, relation and age affected: | No |
| Any dietary restrictions? If yes, explain: | No |
| Do you wear glasses or contact lenses? Are you near or far-sighted? | No |
| Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused: | Yes - Dust and dust mites; Naproxen: Causes swollen neck and scalp |
| CMV IgG Antibody | Negative |
| CMV IgM Antibody | Negative |
| Note any comments regarding above items: | N/A |
Family Medical HistorySee list of questions asked here
Your Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 49 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 50 | |
| Health Problem | Healthy, possible high cholesterol | |
| Living / Dead | Living |
Brothers
Your Brother 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 21 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 50 | |
| Health Problem | Heart failure, no prior problems | 49 |
| Living / Dead | Dead |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 78 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 47 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 44 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 39 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 4
| Question | Response | Comment/Age Affected |
| Current age or age at death | 37 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 5
| Question | Response | Comment/Age Affected |
| Current age or age at death | 34 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 6
| Question | Response | Comment/Age Affected |
| Current age or age at death | 33 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 76 | |
| Health Problem | Diabetes requiring insulin | 55 |
| Nosocomial infection following bypass surgery | 76 | |
| Living / Dead | N/A | Dead |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 76 | |
| Health Problem | Glaucoma | 60 |
| Living / Dead | Living |
Your Father's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 58 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Religion:
| Faith | Christian |
| Denomination | Catholic |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to donor Personal Profile: September 2017. |
| Updates - Medical | No change to donor Medical Profile: September 2017. |
| Updates - Family Medical History | Update received September 2017: Mother had a melanoma on her foot; it was successfully removed. |