PHYSICAL CHARACTERISTICS
 

Height: 5' 11"	Weight: 145	Hair Color: Dark Brown
Eye Color: Hazel	Hair Type: Wavy	Complexion: Fair
Race: Caucasian	Mother's Ethnic Background: Scottish  Father's Ethnic Background: Irish
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:	Emphysema:	Mental retardation:
Anemia:	Epilepsy:	Miscarriages:
Asthma:	Glaucoma:	Stillbirths:
Blindness:	Goiter:	Migraine:
Cancer:	Gout:	Muscular dystrophy:
Cataracts:	Heart attack: PGF	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: The donor's M (age 50), F (53), brother (20), 2 sisters (25 and 27), PGM (87), MGF (76), MGM (78), PA (63), PU (56), and MA (51) are all living and reported to be in good health. The PGF died at 83 of congestive heart failure. The donor reports none of the conditions above as being present in his family, except "Heart attack."
 

EDUCATION:	Subject of study	Location of University	Type of University
> 1 year college
Baccalaureate Degree	Biology	Oregon	private liberal arts college
Master's Degree
Professional Degree

OCCUPATION: Masters degree student, Biology; part-time stream biologist at Department of Fish and Wildlife; part-time clerk at outdoor store.

GOAL: Doctorate in Fisheries and Wildlife     YEAR OF BIRTH: 1969     RELIGION: Protestant

Social History:

1. Do you have any special talents?
 

2. Are there any special talents that seem to run in your family? (athletics, music, artistic, etc.)

We all seem to thrive on our own individual goals and accomplishments.
 

3. What are your interests and hobbies?

Conservation, genetics, cycling as an alternative form of transportation, physically challenging outdoor activies, critical thinking, classical music.
 

4. What did you enjoy studying in high school and college?

English, chemistry, macrobiology.
 

5. High School GPA 4.0     College GPA 3.1     I.Q.
 

6. How would you describe your personality characteristics?

Thoughtful, competitive, athletic.
 

7. Undergraduate major: Life Sciences

Graduate major:

Additional Descriptive Characteristics:
 

Handedness: Foot/Shoe Size:

Hairy Chest: Hairy: Beard Color:

Any Distinguishing Features (Dimples, Cleft Chin, Roman Nose, Freckles, etc.):

Acne problems:

Reactivity/Sensitivity to sun exposure:

Do you smoke?

Family Social History:
 

Relatives	Education	Occupation	Interests
PGF	high school	engineering	fishing
PGM	high school	homemaker	family interactions
MGF	high school	agriculture	gardening
MGM	college	homemaker	knitting
Father	graduate degree	engineering	outdoor activities
Mother	graduate degree	health services	outdoor activiies
Brother	undergraduate  degree	biologist	outdoors
Sister	graduate	business	travel, international
Sister	undergraduate degree	homemaker	children
Cousin	graduate degree	education	conceptual thinking
Aunt	graduate degree	education	sailing, social services
Aunt	undergraduate degree	education	community structures
Uncle	graduate degree	engineering	sailing