Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
5'10"
(177 cm) |
Weight:
168 lb
(76 kg) |
Eye Color:
Hazel
|
Hair:
Brown/
Straight |
Skin Tone:
Medium
|
Ancestry:
Caucasian
|
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Blood Type:
A+
|
Ethnic Background:
Swedish/Norwegian
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Education:
AAS/Law Enforcement
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Occupation:
Military
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Interests:
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Camping, Hiking, Mechanics, Reading, Running, The outdoors
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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: | Yes - Paternal grandfather, age unknown (no treatment) |
| 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 | 65 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 68 | |
| Health Problem | Color blind (blue/yellow; the donor has normal color vision) | |
| Living / Dead | Living |
Brothers
Your Brother 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 51 | (Paternal half brother) |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Brother 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 26 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Sisters
Your Sister 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 48 | (Paternal half sister) |
| Health Problem | Healthy | |
| Living / Dead | Living |
Daughters
Your Daughter 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 3 | |
| Health Problem | Ear infections, tubes placed in ears | 1 |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 91 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 85 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
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 Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 58 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 70 | |
| Health Problem | Alcoholism, no treatment, unknown age of onset | |
| Heart attack, no treatment | 70 | |
| Cause of death: Heart attack | 70 | |
| Living / Dead | Dead |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 89 | |
| Health Problem | Heart failure, no treatment | 89 |
| Cause of death: Heart failure | 89 | |
| Living / Dead | Dead |
Your Father's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 74 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 75 | |
| Health Problem | Stroke, no treatment | 75 |
| Cause of death: Stroke | 75 | |
| Living / Dead | Dead |
Religion:
| Faith | Other |
| Denomination | Agnostic |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to donor Personal Profile: September 2014, July 2015, August 2018, May 2019, February 2020, March 2021, February 2022, February 2023. |
| Updates - Medical | No change to donor Medical Profile: September 2014, July 2015, August 2018, May 2019, February 2020, March 2021, February 2022, February 2023. |
| Updates - Family Medical History | No change to donor Family Medical History: September 2014, July 2015, August 2018, May 2019, February 2020. Update received March 2021: Donor reported death of Maternal Grandfather at age 91. No change to donor Family Medical History: February 2022, February 2023. |