Extended Donor Profile for Donor: LARS alias 3107
Transcription
Extended Donor Profile for Donor: LARS alias 3107
Extended Donor Profile for Donor: LARS alias 3107 1 The donor voluntarily provided the following information. This information will be disclosed to future parents as an aid in their selection process. A: PHYSICAL DESCRIPTION: 1. Race: Caucasian/Scandinavian. 2. What blood type do you have: B + 3. Height: 6’ 2’’ 4. Weight: 176lbs 5. Hair color: Brown 6. Eye color: Blue/green 7. What year were you born? 1979 8. Build: Medium 9. Color of eyebrow? Dark 10. Curly or straight hair? Straight 11. Hair color as a young child (0-4 years): Brown 12. Curly or straight hair as a young child (0-4 years): Straight 13. Is your hair thin, medium, or thick? Medium 14. Color of beard: Red 15. Do you wear prescription lenses? No 16. At what age did you start wearing prescription lenses? 17. Are you left or right handed? Right handed 18. Shoe size: 10 19. General clothing size: Mostly Large 20. Do you have any allergies? No 21. Do you suffer from any physical abnormalities? No 22. What is your resting heart rate? 40 beats per minute Extended Donor Profile for Donor: LARS alias 3107 2 23. What is your skin tone? Fair. I tan evenly and don’t burn too easily. B: ACADEMICS: 1. In which percentile did you place in high school? Top 10%. 2. Which year did you graduate from high school? 1998 3. What did you do immediately after high school? Worked as a carpenter 4. In which percentile did you place during your university studies? I am a carpenter 5. Which year did you graduate from university? 6. Are you currently in school or do you work? I work 7. Describe your current school or job briefly. I am a carpenter and I am planning to study as building technician/engineer 8. How many years have you been in school (including kindergarten)? 16 years and 5 to go 9. How many additional years do you plan on being in school? 5 years 10. What is your final degree goal? I want to work as an engineer 11. What is your native language? Danish 12. Which other languages do you speak? I have taken 8 years of English and 6 years of German. 13. Are you more scientific, artistic or humanities oriented? I am definitely more scientific 14. What is your career goal? I want to build houses. 15. Have you been in the military? No, I did not get drafted and I chose to concentrate on my education instead. Extended Donor Profile for Donor: LARS alias 3107 3 C: PERSONALITY: 1. What is your relationship status? I have a girlfriend. We have been together for 2 years. We are planning to get married 2. Which words describe your personality: Spontaneous, creative, witty, leader, optimistic, easy going, healthy looks 3. Which sports do you like to participate in? Soccer, running, skiing, climbing, surfing, waterskiing, and all other water sports 4. Which sports did you play as a child? I played soccer for one season (as a goalie), and I spent lots of time fishing. 5. Which sports do you enjoy watching? I don’t watch sports I only participate in real life 6. Describe any additional hobbies you have: I like swimming 7. Do you play any musical instruments? I have played a guitar for a period but I was never very good 8. Are you a member of a church? Member of the Danish church. 9. Which is your favorite color? Blue, I really like the water 10. Favorite animal: Horse, because it is a very powerful animal 11. Favorite food: T-bone steak and baked potatoes 12. Favorite type of music: I prefer pop and rock 13. Favorite car: Citroen (French) 14. Favorite pet: Dog , Boxer 15. How much sleep do you get on an average night? 7.5 hours (and I really enjoy it!) 16. Do you eat healthy? I find it important to eat healthy. I try to avoid all chemical additives in my food 17. Are you a smoker? No, I do not smoke 18. Do you drink alcohol? I am a social drinker and enjoy alcohol occasionally. 19. Do you ride a bicycle? Yes on a hot day I often ride just for the exercise 20. What is your most memorable childhood experience? I remember our first boat and our many fishing trips Extended Donor Profile for Donor: LARS alias 3107 4 21. To which countries have you traveled? Norway, Sweden, Germany, Poland, Austria 22. Describe one of your favorite vacations to another country: A few years ago I went climbing in Sweden together with a lot of other young people. I met my girlfriend there 23. Describe a few things you like the most about your own country? I think that Denmark has many good sides. One of the best is the socialized health care and a social network for the poorer people of society. Another really nice thing about Denmark is that it is almost surrounded by water and there is never a long way to go swimming 24. Describe some of your strong sides. My personal skills are one of my strongest sides. I meet new people very easily. I enjoy working in a team but can also motivate myself. Sports skills are also one of my strong sides. I like to learn new sports. Academically I am strongest in the sciences. 25. Describe some of your weak sides. I am a bit lazy and I am often not good to tell about my problems. Extended Donor Profile for Donor: LARS alias 3107 5 D: FAMILY INFORMATION: Paternal Grandfather Age70 Alive? Yes Ethnicity: Danish Occupation: Farmer Height: 175cm Weight: 80kg Build: Normal Hair color: Dark brown Eye color: Blue/grey Heart conditions: No Any genetic disorders: No Maternal Grandfather Paternal Grandmother Age: 65 Alive? Yes Ethnicity: Danish Occupation: Home maker Height: 180cm Weight: 65kg Build: Slim Hair color: Brown Eye color: Blue Heart conditions: No Any genetic disorders: No Age: 76 Alive? No Ethnicity: Danish Occupation: Clothes shop owner Height: 180 Weight: 75kg Build: Normal Hair color: Grey Eye color: Blue/grey Heart conditions: No Any genetic disorders: No Father Brother Age: 78 Alive? Yes Ethnicity: Danish Occupation: Home Maker Height: 160 Weight: 60kg Build: Normal Hair color: Grey Eye color: Blue/grey Heart conditions: No Any genetic disorders: No My grandmother is the best cook I know!! Mother Age: 45 Alive? Yes Ethnicity: Danish Education: Wood worker Musical? Not at all Right or left handed? Right handed Occupation: Teacher Height: 170cm Weight: 172kg Build: Normal Hair color: Black Eye color: Blue/grey Heart conditions: No Any genetic disorders: No Languages: English, Danish, and German Glasses? Yes Age: 9 Ethnicity: Danish Occupation: Height : Normal Weight: Normal Build : Normal Hair color: Brown Eye color: Blue Heart conditions: No Maternal Grandmother Age: 42 Alive? Yes Ethnicity: Danish Education: Sewing Musical? No Right or left handed? Right handed Occupation: Dressmaker Height: 180cm Weight: 60kg Build: Slim Hair color: Light blond Eye color: Blue Heart conditions: No Any genetic disorders: No Languages: English, Danish, and German Glasses? Yes Brother Full or half? Full Age: 12 Alive? Yes Ethnicity: Danish Occupation: Height: normal Build: Athletic Hair color: Brown Eye color: Blue Heart conditions: No Any genetic disorders: No Brother Age:14 Ethnicity: Danish Occupation: Height: Tall Weight: Normal Build: Normal Hair color: Brown Eye color: Grey Heart conditions: No I have 3 smaller brothers and one older sister. My sister gave birth to twins last year Extended Donor Profile for Donor: LARS alias 3107 6 Do you have any children? No If yes, please describe in detail (include physical description, personality, medical information….): E: MEDICAL INFORMATION: Do you have any medical conditions? no If yes, please list: F: PERSONAL MESSAGE FROM DONOR: Hand written: Motivation for donation, personal message to family, further information about yourself….