Physical
Height:
6'5"
(195 cm) |
Weight:
184 lb
(83 kg) |
Eye Color:
Brown
|
Hair:
Brown/
Straight |
Skin Tone:
Medium
|
Ancestry:
Caucasian
|
Blood Type:
A+
|
Ethnic Background:
English-German-Irish/Italian
|
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Education:
BS/Physical Education
|
Occupation:
Teacher
|
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Interests:
|
Exercise, Gardening, Travel
|
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 | Positive |
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 | 62 | |
Health Problem | Osteoarthritis, controlled with over-the-counter medication | 60 |
Living / Dead | Living |
Brothers
Your Brother 1
Question | Response | Comment/Age Affected |
Current age or age at death | 34 | |
Health Problem | Situational depression, controlled with medication | 28 |
Living / Dead | Living |
Your Mother's Father
Question | Response | Comment/Age Affected |
Current age or age at death | 85 | |
Health Problem | Glaucoma, treated with medicated eye drops | 82 |
Dementia, no treatment | 85 | |
Congestive heart failure, no treatment | 85 | |
Cause of death: Congestive heart failure | 85 | |
Living / Dead | Dead |
Your Mother's Mother
Question | Response | Comment/Age Affected |
Current age or age at death | 87 | |
Health Problem | High blood pressure, controlled with diet modifications and medication | 80 |
Pneumonia, hospitalization | 87 | |
Cause of death: Pneumonia | 87 | |
Living / Dead | Dead |
Your Mother's Sisters 1
Question | Response | Comment/Age Affected |
Current age or age at death | 61 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Brothers 1
Question | Response | Comment/Age Affected |
Current age or age at death | 64 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Father
Question | Response | Comment/Age Affected |
Current age or age at death | 64 | |
Health Problem | Lung cancer (smoker), no treatment | 64 |
Cause of death: Lung cancer | 64 | |
Living / Dead | Dead |
Your Father's Mother
Question | Response | Comment/Age Affected |
Current age or age at death | 77 | |
Health Problem | Broken hip due to fall, hospitalized | 77 |
Cause of death: Complications of broken hip | 77 | |
Living / Dead | Dead |
Your Father's Sisters 1
Question | Response | Comment/Age Affected |
Current age or age at death | 65 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Sisters 2
Question | Response | Comment/Age Affected |
Current age or age at death | 59 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 1
Question | Response | Comment/Age Affected |
Current age or age at death | 44 | |
Health Problem | Mentally handicapped since birth, no treatment | |
Living / Dead | Living |
Religion:
Faith | Christian |
Denomination | Lutheran |
Updates to Profile
Update Available | Yes |
Updates - Personal | No change to donor Personal Profile: April 2015, November 2018, August 2019, June 2020, June 2022, November 2023. |
Updates - Medical | No change to donor Medical Profile: April 2015, November 2018, August 2019, June 2020, June 2022, November 2023. |
Updates - Family Medical History | Update received April 2015: Brother has died by suicide at age 35. No change to donor Family Medical History: November 2018, August 2019, June 2020. Update received June 2022: Donor reports the birth of a healthy daughter, now aged 2. Update received November 2023: Donor's Mother was diagnosed with breast cancer at age 67, treated with surgery to remove tumor. |