Physical
|
Height:
5'5"
(165 cm) |
Weight:
136 lb
(61 kg) |
Eye Color:
Brown
|
Hair:
Black/
Straight |
Skin Tone:
Medium
|
Ancestry:
Asian
|
|
Blood Type:
A+
|
Ethnic Background:
Vietnamese/Vietnamese
|
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|
Education:
BS/Mat. Sci. and Engineering
|
Occupation:
Quality Control Technician
|
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|
Interests:
|
Music, Video games
|
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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 | 52 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 61 | |
| Health Problem | Heart disease, blockage treated with surgery | 60 |
| Living / Dead | Living |
Brothers
Your Brother 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 22 | |
| Health Problem | Mild seafood allergies to crab, shrimp, and squid | 14 |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 78 | |
| Health Problem | Diabetes mellitus, treated with insulin therapy | 50 |
| Living / Dead | Living |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 74 | |
| Health Problem | Undiagnosed weather-related knee pain, treated with acupuncture. | 68 |
| Living / Dead | Living |
Your Mother's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 43 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 41 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 38 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 4
| Question | Response | Comment/Age Affected |
| Current age or age at death | 31 | |
| Health Problem | Hepatitis B, treated with medication | 28 |
| Living / Dead | Living |
Your Mother's Sisters 5
| Question | Response | Comment/Age Affected |
| Current age or age at death | 2 | |
| Health Problem | Cause of death: Complications from flu | 2 |
| Living / Dead | Dead |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 58 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 46 | |
| Health Problem | Diabetes mellitus, treated with insulin | 43 |
| Living / Dead | Living |
Your Mother's Brothers 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 36 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 4
| Question | Response | Comment/Age Affected |
| Current age or age at death | 36 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 62 | |
| Health Problem | High blood pressure, no treatment received | 62 |
| Cause of death: Complications due to untreated high blood pressure | 62 | |
| Living / Dead | Dead |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 78 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
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 | 43 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Sisters 3
| 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 | 56 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 46 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 44 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 4
| Question | Response | Comment/Age Affected |
| Current age or age at death | 38 | |
| Health Problem | Stress-related anxiety, little to no treatment received | 18 |
| Living / Dead | Living |
Religion:
| Faith | Christian |
| Denomination | Catholic |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | Update received May 2010: Donor completed his Bachelor's degree and is working as an Entrepreneur. Update received February 2012: Occupation changed to Quality Control technician. |
| Updates - Medical | No change to donor Medical Profile: May 2010, February 2012. |
| Updates - Family Medical History | No change to donor Family Medical History: May 2010, February 2012. |

Physical
Medical
Family Medical History
Religion
Updates to Profile