Physical
Height:
167 cm
(5'6") |
Weight:
78 kg
(173 lb) |
Eye Color:
Hazel
|
Hair:
Brown/
Straight |
Skin Tone:
Medium
|
Ancestry:
Caucasian
|
Blood Type:
O+
|
Ethnic Background:
German/German
|
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Education:
AA/Speech Communication
|
Occupation:
General Manager
|
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Interests:
|
Comedy, History, International 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: | Yes - Some laundry detergents causes rash |
CMV IgG Antibody | Positive |
CMV IgM Antibody | Negative |
Note any comments regarding above items: | Donor screening did not include: HCV by NAT. For more information, visit www.cryolab.com. |
Family Medical HistorySee list of questions asked here
Your Mother
Question | Response | Comment/Age Affected |
Current age or age at death | 56 | |
Health Problem | Overweight (15-20 lbs) | 50 |
Migraines | 20 | |
Living / Dead | Living |
Your Father
Question | Response | Comment/Age Affected |
Current age or age at death | 57 | |
Health Problem | Lost 25 pounds on the Atkins diet | 50 |
Living / Dead | Living |
Brothers
Your Brother 1
Question | Response | Comment/Age Affected |
Current age or age at death | 28 | |
Health Problem | Healthy | |
Living / Dead | Living |
Sisters
Your Sister 1
Question | Response | Comment/Age Affected |
Current age or age at death | 30 | |
Health Problem | Allergic to nuts and bee stings | |
Knee surgery | 20 | |
Living / Dead | Living |
Your Sister 2
Question | Response | Comment/Age Affected |
Current age or age at death | 26 | |
Health Problem | Knee surgery | 18 |
Living / Dead | Living |
Your Sister 3
Question | Response | Comment/Age Affected |
Current age or age at death | 20 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Mother's Father
Question | Response | Comment/Age Affected |
Current age or age at death | 88 | |
Health Problem | Colon cancer | 43 |
Prosthetic leg from WWII injury | 20 | |
Living / Dead | Dead |
Your Mother's Mother
Question | Response | Comment/Age Affected |
Current age or age at death | 88 | |
Health Problem | High blood pressure | 60 |
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 Sisters 2
Question | Response | Comment/Age Affected |
Current age or age at death | 54 | |
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 | 82 | |
Health Problem | Alzheimer's | 82 |
Living / Dead | Living |
Your Father's Mother
Question | Response | Comment/Age Affected |
Current age or age at death | 70 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Sisters 1
Question | Response | Comment/Age Affected |
Current age or age at death | 57 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 1
Question | Response | Comment/Age Affected |
Current age or age at death | 62 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 2
Question | Response | Comment/Age Affected |
Current age or age at death | 54 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 3
Question | Response | Comment/Age Affected |
Current age or age at death | 40 | |
Health Problem | Healthy | |
Living / Dead | Living |
Your Father's Brothers 4
Question | Response | Comment/Age Affected |
Current age or age at death | 36 | |
Health Problem | Acne until late 20's | 20 |
Living / Dead | Living |
Religion:
Faith | Christian |
Denomination | Lutheran |
Updates to Profile
Update Available | N/A |
Updates - Personal | N/A |
Updates - Medical | N/A |
Updates - Family Medical History | N/A |