Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
5'8"
(172 cm) |
Weight:
212 lb
(96 kg) |
Eye Color:
Blue
|
Hair:
Blond/
Straight |
Skin Tone:
Light
|
Ancestry:
Caucasian
|
|
Blood Type:
O+
|
Ethnic Background:
German/German-Native American
|
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Education:
AAS/Criminal Justice
|
Occupation:
Compliance Rep. (State Gov.)
|
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Interests:
|
Outdoors, Working out
|
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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 - (Near-sighted before laser surgery) |
| Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused: | Yes - Dust/dust mites: Cause sneezing |
| 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 | 56 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 43 | |
| Health Problem | Healthy | |
| Cause of death: Hunting accident | 43 | |
| Living / Dead | Dead |
Brothers
Your Brother 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 39 | Maternal half brother |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Brother 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 31 | Paternal half brother |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Brother 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 19 | Paternal half brother |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Brother 4
| Question | Response | Comment/Age Affected |
| Current age or age at death | 18 | Paternal half brother |
| Health Problem | Healthy | |
| Living / Dead | Living |
Sisters
Your Sister 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 34 | Maternal half sister |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Sister 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 33 | Maternal half sister |
| 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 Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 71 | |
| Health Problem | Heart disease, treatment unknown | 65 |
| Cause of death: Heart disease | 71 | |
| Living / Dead | Dead |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 83 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 62 | (twin) |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 62 | (twin) |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 68 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 66 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 0 | (unknown) |
| Health Problem | No medical history available (estranged) | |
| Cause of death and age at death are unknown | ||
| Living / Dead | Dead |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 75 | |
| Health Problem | Heart disease (smoker), treated with medication | 55 |
| Cause of death: Heart disease | 75 | |
| Living / Dead | Dead |
Your Father's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 61 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 60 | |
| 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: August 2018, November 2018, March 2019. |
| Updates - Medical | No change to donor Medical Profile: August 2018, November 2018, March 2019. |
| Updates - Family Medical History | No change to donor Family Medical History: August 2018, November 2018, March 2019. |