Physical
Medical
Family Medical History
Religion
Updates to ProfilePhysical
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Height:
177 cm
(5'10") |
Weight:
73 kg
(162 lb) |
Eye Color:
Brown
|
Hair:
Brown/
Straight |
Skin Tone:
Medium Light
|
Ancestry:
Caucasian
|
|
Blood Type:
A+
|
Ethnic Background:
Italian/Luxembourger-Norwegian-Scand.
|
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|
Education:
BA/Journalism
|
Occupation:
Fundraiser, Grant Writer
|
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|
Interests:
|
Fishing, Music, Photography, Writing
|
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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? | Yes - Near-sighted |
| 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 | 52 | |
| Health Problem | Hypothyroidism, controlled with medication | 20 |
| Living / Dead | Living |
Your Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 54 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Brothers
Your Brother 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 21 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Sisters
Your Sister 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 30 | |
| Health Problem | Mild generalized anxiety, controlled with medication | 21 |
| Living / Dead | Living |
Your Sister 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 25 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Sister 3
| Question | Response | Comment/Age Affected |
| Current age or age at death | 23 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 86 | |
| Health Problem | Heart disease, treated with medication and pacemaker | 86 |
| Living / Dead | Living |
Your Mother's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 78 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Mother's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 50 | |
| Health Problem | Colon cancer, attempted treatment with surgery and chemotherapy | 49 |
| Cause of death: Colon cancer | 50 | |
| Living / Dead | Dead |
Your Father's Father
| Question | Response | Comment/Age Affected |
| Current age or age at death | 66 | |
| Health Problem | Diabetes mellitus requiring insulin therapy | 65 |
| Pancreatic cancer, attempted treatment with chemotherapy | 65 | |
| Cause of death: Pancreatic cancer | 66 | |
| Living / Dead | Dead |
Your Father's Mother
| Question | Response | Comment/Age Affected |
| Current age or age at death | 78 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Sisters 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 58 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Sisters 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 55 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 1
| Question | Response | Comment/Age Affected |
| Current age or age at death | 57 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Your Father's Brothers 2
| Question | Response | Comment/Age Affected |
| Current age or age at death | 52 | |
| Health Problem | Healthy | |
| Living / Dead | Living |
Religion:
| Faith | Other |
| Denomination | Agnostic |
Updates to Profile
| Update Available | Yes |
| Updates - Personal | No change to donor Personal Profile: October 2015. |
| Updates - Medical | No change to donor Medical Profile: October 2015. |
| Updates - Family Medical History | No change to donor Family Medical History: October 2015. |