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ID# RR350
ID# | Heritage | Blood Type | Eye Color | Hair | Complexion | Height | Weight | Years of College | Occupation |
RR350 | French, Irish | O- | Green | Strawberry Blonde, Straight | Fair | 5'10" | 200 | 8 | Graduate Student and Coach |
Identification #RR350 | Pregnancy Proven – Yes | ||
Physical & Personal Characteristics | |||
Height | 5’10” | Weight | 200 |
Eye Color | Green | Complexion | Fair |
Hair | Strawberry Blonde, Straight | Right Handed X | Left Handed X |
Religion Born Into | Roman Catholic | Married No | |
Heritage | French, Irish | Occupation Graduate Student and Coach | Years of College 8 |
Interests Sports | |||
Notes PW (IUI) vials only |
Test Results | Test Results | ||
Blood Type | O- | HIV 1/2 Ab; HIV 1 Ag | Nonreactive/Nonreactive |
Chlamydia | Negative | HTLV-1,2 Ab | Nonreactive |
Chromosome Analysis | Normal Male 46XY | Neisseria gonorrhea | Negative |
CMV Screen | Negative | SGPT | Within normal limits |
CMV, IgM/Culture | Not applicable | Sickle cell | Not applicable |
Cystic Fibrosis | Negative for 37 Common Mutations | Syphilis, antibody MHA-TP | Nonreactive |
HbsAg | Nonreactive | Tay Sachs & Canavan | Not applicable |
HbcAb | Nonreactive | Hepatitis C, Ab | Nonreactive |
Thalassemia | Normal adult hemoglobin | HCVRNA/HIV-1 RNA | Nonreactive/Nonreactive |
Notes |
Donor & Family Health History | ||
Medical Problem | Donor | Family |
Heart | None |
Father: High blood pressure Paternal Grandfather: Heart Attack |
Blood | None | None |
Respiratory | None | None |
Gastrointestinal | None | None |
Metabolic/Endocrine | None | Father: Became diabetic in his 50s/controlled with diet |
Urinary | None | None |
Genital / Reproductive | None | None |
Neurological | None | None |
Mental Health | None | None |
Muscles / Bones / Joints | None | None |
Sight / Sound / Smell | None | None |
Skin | None | None |
Other | None | None |
Family History | |||
Family Member | Occupation | Level of Schooling | |
Mother | Secretary | High School | |
Father | Surveyor | High School | |
Family Member | Age if Living | Age at Death | Cause of Death |
Mother | 51 | ||
Father | 59 | ||
Maternal Grandmother | 83 | ||
Maternal Grandfather | 71 | Unknown | |
Paternal Grandmother | 88 | ||
Paternal Grandfather | 59 | Heart Disease | |
Sisters | 31 | ||
Brothers | 27 |
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