Physical
|
Height:
6'0"
(182 cm) |
Weight:
147 lb
(66 kg) |
Eye Color:
Green
|
Hair:
Brown/
Straight |
Skin Tone:
Medium Light
|
Ancestry:
Caucasian
|
|
Blood Type:
B-
|
Ethnic Background:
German/German
|
||||
|
Education:
MEd/Educational Psychology
|
Occupation:
Student
|
||||
|
Interests:
|
Outdoors
|
||||
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: | No |
| 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 | 57 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 59 | |
| Health Problem | Kidney cancer, treated with surgery | 59 |
| Living / Dead | Living |
Sisters
Your Sister 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 33 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 51 | |
| Health Problem | Heart attack (smoker), no treatment | 51 |
| Cause of death: Heart attack | 51 | |
| Living / Dead | Dead |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 88 | |
| Health Problem | Stroke | 88 |
| Cause of death: Stroke | 88 | |
| Living / Dead | Dead |
Your Mother's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 64 | |
| Health Problem | Anorexia nervosa, unknown age of diagnosis, treated with hospitalization | |
| Cause of death: Complications of Anorexia nervosa | 64 | |
| Living / Dead | Dead |
Your Mother's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 52 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 65 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 55 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 54 | |
| Health Problem | Lung cancer (smoker and mine worker), treated with radiation therapy | 54 |
| Cause of death: Lung cancer | 54 | |
| Living / Dead | Dead |
Your Mother's Brothers 4
| Question | Response | Comment/Age Affected |
| Current age or age at death | 53 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 60 | |
| Health Problem | Heart attack (smoker), no treatment | 60 |
| Cause of death: Heart attack | 60 | |
| Living / Dead | Dead |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 68 | |
| Health Problem | Healthy | |
| Cause of death: Heart failure | 68 | |
| Living / Dead | Dead |
Your Father's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 64 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Religion:
| Faith | Christian |
| Denomination | Non-denominational |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to donor Personal Profile: September 2015, June 2016. Update received May 2022: DOnor has earned an M.Ed. Educational Psychology; Occupation has changed to School Counselor. |
| Updates - Medical | No change to donor Medical Profile: September 2015, June 2016, May 2022. |
| Updates - Family Medical History | No change to donor Family Medical History: September 2015, June 2016. Update received May 2022: Donor reports the birth of a healthy daughter. |

Physical
Medical
Family Medical History
Religion
Updates to Profile