Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
5'11"
(180 cm) |
Weight:
220 lb
(99 kg) |
Eye Color:
Hazel
|
Hair:
Brown/
Straight |
Skin Tone:
Light
|
Ancestry:
Caucasian
|
|
Blood Type:
O+
|
Ethnic Background:
English-Welsh/English-Irish-Native American
|
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|
Education:
BS/Business Administration
|
Occupation:
Private Banker
|
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Interests:
|
Charity, Movies, Sports
|
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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 | 59 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 58 | |
| Health Problem | Diabetes mellitus, treated with diet modification | 58 |
| Living / Dead | Living |
Brothers
Your Brother 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 30 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Daughters
Your Daughter 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 8 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Daughter 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 5 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Daughter 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 5 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Daughter 4
| Question | Response | Comment/Age Affected |
| Current age or age at death | 1 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Daughter 5
| Question | Response | Comment/Age Affected |
| Current age or age at death | 1 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 70 | |
| Health Problem | Rectal cancer, no treatment | 70 |
| Cause of death: Rectal cancer | 70 | |
| Living / Dead | Dead |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 81 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 62 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 74 | |
| Health Problem | Pancreatic cancer, no treatment | 74 |
| Cause of death: Pancreatic cancer | 74 | |
| Living / Dead | Dead |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 76 | |
| Health Problem | Heat stroke | 76 |
| Cause of death: Heat stroke | 76 | |
| Living / Dead | Dead |
Your Father's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 55 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Religion:
| Faith | Christian |
| Denomination | Christian Science |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to donor Personal Profile: April 2012, October 2012, December 2012. |
| Updates - Medical | No change to donor Medical Profile: April 2012, October 2012, December 2012. |
| Updates - Family Medical History | No change to donor Family Medical History: April 2012; October 2012. Update received December 2012: Donor reports the death of his maternal grandmother at age 83 from a stroke. |