Donor Profile RR364*
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| Identification # RR364* | Pregnancy Proven Yes |
| Physical & Personal Characteristics |
| Date of Birth (Y) 1978 | Place of Birth India |
| Height 5'11" | Weight 160 |
| Eye Color Brown | Complexion Medium, Asian |
| Hair Black, Straight | Right Handed X | Left Handed |
| Religion Born Into Hindu | Married No | |
| Heritage Indian | Occupation Engineering | Years of College 8 |
| Interests tennis and jogging |
| Notes |
| Test Results |
| Blood Type A+ | HIV 1/2 Ab Nonreactive |
| Chlamydia Negative | HTLV-1,2 Ab Nonreactive |
| Chromosome analysis Normal Male 46 XY | Neisseria gonorrhea Nonreactive |
| CMV Screen Positive | SGPT Normal |
| CMV, IgM/Culture No Growth | Sickle cell Not Applicable |
| Cystic Fibrosis Noncarrier of 51 Common Mutations | Syphilis, antibody Nonreactive |
| HbsAg Nonreactive | Tay Sachs & Canavan Not Applicable |
| HbcAb Nonreactive | Hepatitis C, Ab Nonreactive |
| Thalassemia Normal Adult Hemoglobin | HCVRNA/HIV-1 RNA Nonreactive |
| Notes |
| Donor & Family Health History |
| Medical Problem | Donor | Relative |
| Heart | None | None |
| Blood | None | None |
| Respiratory | None | None |
| Gastrointestinal | None | None |
| Metabolic/Endocrine | None | None |
| Urinary | None | None |
| Genital/Reproductive System | None | None |
| Neurological | None | None |
| Mental Health | None | None |
| Muscles / Bones / Joints | None | None |
| Sight / Sound / Smell | None | None |
| Skin | None | Mother and brother: acne |
| Other | None | None |
| Family History |
| Family Member | Occupation | Level of Schooling |
| Mother | Homemaker | High School |
| Father | Small business owner | High School |
| |
| Family Member | Age if Living | Age at Death | Cause of Death |
| Mother | 50 | | |
| Father | 55 | | |
| Maternal Grandmother | 70 | | |
| Maternal Grandfather | 75 | | |
| Paternal Grandmother | | 80 | Old Age |
| Paternal Grandfather | | 55 | Accident |
| Sisters | | | |
| Brothers | 21 | | |