Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
5'7"
(170 cm) |
Weight:
140 lb
(63 kg) |
Eye Color:
Brown
|
Hair:
Brown/
Straight |
Skin Tone:
Light
|
Ancestry:
Caucasian
|
|
Blood Type:
A+
|
Ethnic Background:
Spanish/French Canadian
|
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Education:
BA/Sociology
|
Occupation:
Records Services
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Interests:
|
Athletics, Drums, Hiking, Travel
|
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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 |
| Current age or age at death | 57 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father
| Question | Response |
| Current age or age at death | 64 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Brothers
Your Brother 1
| Question | Response |
| Current age or age at death | 28 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Father
| Question | Response |
| Current age or age at death | 78 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Stroke |
Health Problems
Disease
Age Diagnosed
Treatment For Condition
Stroke
78
None
Your Mother's Mother
| Question | Response |
| Current age or age at death | 79 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Sisters 1
| Question | Response |
| Current age or age at death | 62 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Mother's Sisters 2
| Question | Response |
| Current age or age at death | 58 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Your Father's Father
| Question | Response |
| Current age or age at death | 92 |
| Living / Dead | Dead |
| Cause of death and any treatment prior to death | Natural causes |
Health Problems
Healthy
Your Father's Mother
| Question | Response |
| Current age or age at death | 97 |
| Living / Dead | Living |
| Cause of death and any treatment prior to death | N/A |
Health Problems
Healthy
Religion:
| Faith | Other |
| Denomination | Agnostic |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | Update received August 2019: Donor's occupation has changed from Experiential Leadership Educator to Records Services. No change to profile: May 2020. Update received May 2021: Donor's occupation has changed from Records Services to Unemployed. No change to donor Personal Profile: April 2022. Update received July 2023: Occupation has changed to Recreation Services Leader. |
| Updates - Medical | No change to Medical Profile: August 2019, May 2020, May 2021, April 2022, July 2023. |
| Updates - Family Medical History | No change to Family Medical History Profile: August 2019, May 2020. Update received May 2021: Maternal Grandfather has died after a fall, age unreported. No change to donor Family Medical History: April 2022. Update received July 2023: Paternal Grandmother has died at age 101 from natural causes. |