PHYSICAL CHARACTERISTICS
 

Height: 5' 6"	Weight: 140	Hair Color: Black
Eye Color: Hazel	Hair Type: Wavy	Complexion: Fair to Medium
Race: Caucasian	Mother's Ethnic Background: English, Irish  Father's Ethnic Background: English
Blood Type: O +

FAMILY AND MEDICAL HISTORY
For each item below, if there is a history of the condition, the condition poses a risk of one percent or less to offspring.
The family relationship is indicated.

Alcoholism:	Edema:	Mental disorders:
Allergy: S (hay fever)	Emphysema:	Mental retardation:
Anemia:	Epilepsy:	Miscarriages:
Asthma:	Glaucoma:	Stillbirths:
Blindness:	Goiter:	Migraine:
Cancer: MGM (lung)	Gout:	Muscular dystrophy:
Cataracts:	Heart attack:	Myasthenia gravis:
Cirrhosis:	Heart disease:	Paraplegia:
Cleft palate or lip:	Hemophilia:	Parkinson's:
Club foot:	Hermaphroditism:	Psoriasis:
Color blindness:	Hernia, inguinal:	Sickle cell anemia:
Cystic fibrosis:	Huntington's chorea:	Tay Sachs disease:
Deafness:	Hypertension:	Thalassemia:
Diabetes:	Jaundice:	Undescended testicles:
Dislocated hip:	Juvenile arthritis:
Eczema:	Lymphedema:

ABBREVIATIONS: M=Mother, or Maternal S=Sibling F,P=Father, or Paternal
N=Nephew or Niece GF, GM=Grandfather, Grandmother
A=Aunt U=Uncle C=Cousin

MEDICAL HISTORY COMMENTS: Parents, siblings, aunts, uncles are in excellent health. The PGM is living at age 80, the MGF at 78: both are in good health. The PGF died in an industrial accident at age 52; the MGM, a heavy smoker, died at age 58 of lung cancer.
 

EDUCATION:	Subject of study	Location of University	Type of University
> 1 year college
Baccalaureate Degree	(Biology/Biochemistry)	Oregon	both private and large state universities
Master's Degree
Professional Degree	(science-related)	Oregon	large state university

OCCUPATION: Professional (science-related)

STATE OF BIRTH: probably Oregon     YEAR OF BIRTH: 1966     RELIGION: Lutheran