Fairfax Cryobank |
Donor 2935 Summary Profile |
Questions |
Physical |
Medical |
Family Medical History |
Updates to Profile |
Race | Cauc |
Ethnic Background | English-Czech-German/Scottish-Irish-English |
Height | 6'2'' |
Weight | 182 |
Eye Color | Brown |
Hair | Brown/Wavy |
Skin Tone | Medl |
Blood Type | O- |
Education | BA/Psychology/ |
Occupation | Social Worker |
Interests | Singing/Acting/Cooking |
Medical | ||
Question | Response | |
Any dietary restrictions? If yes, explain: | No | |
Do you wear glasses or contact lenses? Are you near or far-sighted? | Yes - Near sighted | |
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 History |
Your MotherQuestion | Response | Comment/Age Affected | Current age or age at death | 57 | | Health Problem |
Living / Dead | Living | |
|
Your FatherQuestion | Response | Comment/Age Affected | Current age or age at death | 55 | | Health Problem |
Living / Dead | Living | |
|
Sister(s) |
Your Sister 1Question | Response | Comment/Age Affected | Current age or age at death | 25 | | Health Problem |
Living / Dead | Living | |
|
Daughter(s) |
Your Daughter 1Question | Response | Comment/Age Affected | Current age or age at death | 1 | | Health Problem |
Living / Dead | Living | |
|
Your Mother's MotherQuestion | Response | Comment/Age Affected | Current age or age at death | 81 | | Health Problem |
Living / Dead | Living | |
|
Your Mother's Sisters 1Question | Response | Comment/Age Affected | Current age or age at death | 55 | | Health Problem |
Living / Dead | Living | |
|
Your Mother's Brothers 1Question | Response | Comment/Age Affected | Current age or age at death | 51 | | Health Problem |
Living / Dead | Living | |
|
Your Father's FatherQuestion | Response | Comment/Age Affected | Current age or age at death | 78 | | Health Problem |
Living / Dead | Dead | |
|
Your Father's MotherQuestion | Response | Comment/Age Affected | Current age or age at death | 78 | | Health Problem |
Living / Dead | Living | |
|
Your Father's Brothers 1Question | Response | Comment/Age Affected | Current age or age at death | 52 | | Health Problem |
Living / Dead | Living | |
|
Religion: | ||
Faith | Other | |
Denomination | Agnostic |
Updates to Profile | ||
Update Available | Yes | |
Updates - Personal | Update received March 2023: Occupation has changed to Senior Lead Systems Analyst | |
Updates - Medical | No change to donor Medical Profile: March 2023. | |
Updates - Family Medical History | Update received March 2023: Maternal Grandmother has died at age 89, specific cause unreported; Paternal Grandmother has died at age 90, specific cause unreported. |