Physical
|
Height:
5'8"
(172 cm) |
Weight:
145 lb
(65 kg) |
Eye Color:
Brown
|
Hair:
Black/
Wavy |
Skin Tone:
Medium Light
|
Ancestry:
Latino
|
|
Blood Type:
A+
|
Ethnic Background:
Bolivian/El Salvadorian
|
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|
Education:
MS/Mechanical Engineering
|
Occupation:
Technology Service Manager
|
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|
Interests:
|
Martial Arts, Piano and Keyboard player, Reading, Running, Soccer
|
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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? | Yes - Near-sighted |
| Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused: | No |
| CMV IgG Antibody | Positive |
| 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 | 56 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 59 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Brothers
Your Brother 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 36 | |
| Health Problem | Asthma, treating with inhaler | 35 |
| Living / Dead | Living |
Your Brother 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 14 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 32 | |
| Health Problem | Healthy | |
| Cause of death: Injuries sustained in an automobile accident | 32 | |
| Living / Dead | Dead |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 68 | |
| Health Problem | Healthy | |
| Cause of death: Complications from broken hip after falling down stairs | 68 | |
| Living / Dead | Dead |
Your Mother's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 48 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 45 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 42 | |
| Health Problem | Healthy | |
| Cause of death: Complications of infected wound sustained in an automobile accident | 42 | |
| Living / Dead | Dead |
Your Mother's Sisters 4
| Question | Response | Comment/Age Affected |
| Current age or age at death | 35 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 50 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 43 | |
| 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 | 35 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 77 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 23 | |
| Health Problem | Healthy | |
| Cause of death: Injuries sustained in an automobile accident | 23 | |
| Living / Dead | Dead |
Your Father's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 50 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 40 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 54 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 52 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 48 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 4
| Question | Response | Comment/Age Affected |
| Current age or age at death | 41 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 5
| Question | Response | Comment/Age Affected |
| Current age or age at death | 39 | |
| Health Problem | Healthy | |
| Cause of death: Injuries sustained in an automobile accident | 39 | |
| Living / Dead | Dead |
Religion:
| Faith | Christian |
| Denomination | Baptist |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to donor Personal Profile: May 2012. Update received November 2018: Donor's occupation has changed from Student to Technology Service Manager. |
| Updates - Medical | No change to donor Medical Profile: May 2012, November 2018. |
| Updates - Family Medical History | No change to donor Family Medical History: May 2012. Update received November 2018: Paternal grandfather has died, the cause of death was not reported. |

Physical
Medical
Family Medical History
Religion
Updates to Profile