Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
|
Height:
6'0"
(182 cm) |
Weight:
171 lb
(77 kg) |
Eye Color:
Green
|
Hair:
Brown/
Straight |
Skin Tone:
Medium Light
|
Ancestry:
Caucasian
|
|
Blood Type:
A+
|
Ethnic Background:
Italian/Irish-Norwegian
|
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|
Education:
BS/Sociology
|
Occupation:
Computer Technician
|
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|
Interests:
|
Cooking, Hiking, Kayaking, Sailing, Skiing, 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 |
| 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 | 61 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 62 | |
| Health Problem | Gout, managed with medication | 45 |
| Living / Dead | Living |
Brothers
Your Brother 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 34 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Brother 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 31 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Sisters
Your Sister 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 36 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 96 | |
| Health Problem | Organ failure, no treatment | 96 |
| Cause of death: Natural causes, organ failure | 96 | |
| Living / Dead | Dead |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 98 | |
| Health Problem | Organ failure, no treatment | 98 |
| Cause of death: Natural causes, organ failure | 98 | |
| Living / Dead | Dead |
Your Mother's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 60 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 58 | |
| Health Problem | Diabetes mellitus not requiring insulin therapy, controlled with diet management | 55 |
| Living / Dead | Living |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 66 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 64 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 57 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 88 | |
| Health Problem | Stroke, no treatment | 88 |
| Cause of death: Stroke | 88 | |
| Living / Dead | Dead |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 87 | |
| Health Problem | Heart attack, no treatment | 87 |
| Cause of death: Heart attack | 87 | |
| Living / Dead | Dead |
Your Father's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 66 | |
| Health Problem | Fibromyalgia, treated with medication | 58 |
| Living / Dead | Living |
Your Father's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 64 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 65 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 58 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Religion:
| Faith | Christian |
| Denomination | Catholic |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | Update received July 2015: Donor's occupation changed from Chef to Sales. No change to donor Personal Profile: June 2016, September 2018. Update received July 2019: Donor has earned a Tech diploma; his occupation has changed to Computer Technician. |
| Updates - Medical | Update 2015: Donor has been found to be a carrier for Pseudocholinesterase Deficiency in the BCHE gene. Any future sales or vial shipments will require an informed consent. No change to donor Medical Profile: July 2015, June 2016, September 2018, July 2019. |
| Updates - Family Medical History | No change to donor Family Medical History: July 2015, June 2016, September 2018, July 2019. |