Transcript
211 E AST 43 R D S TREET , S UITE 1701, N EW Y ORK , NY 10017 T EL : 212.396.2796 F AX : 212.396.2797
[email protected]
SHORT PROFILE – DONOR CODE 5924 DEMOGRAPHIC AND PHYSICAL DATA Date of birth
(MM/YYYY) :
Place of Birth
08/1992
(state /country ) :
Florida, USA
Hair Color: Dark Brown
Hair Type: Straight
Eye Color: Hazel
Race: Mixed Race
Religion: Catholic
Body Frame: Average
Ethnic Origin
(maternal) :
Height: 6’1”
Chinese/Cuban
Ethnic Origin
Weight (lbs) : 180
(Pleas e circle) :
French Canadian
Complexion: Fair
Are you a Twin? No Yourself
(patern al) :
Blood Type: B+
Family Twins: No Identical
Fraternal
# Identical Twins:
# Fraternal Twins:
PERSONAL FAMILY BACKGROUND Age
Height
Weight
Complexion
Hair Color
Eye Color
Education/Occupation
Mother
54
5’2”
130
Tan
Black
Brown
Masters/Engineer
Father
55
6’5”
190
Fair
Light Brown
Hazel
Masters/Engineer
SIB 1 Male
20
6’3”
140
Fair
Brown
Brown
Bachelors/Student
Comments
DONOR’S OFFSPRING(S) OFS#1
N/A
OFS#2
N/A
GRANDPARENTS BACKGROUND Age
Place of Birth
Health Condition
Cause of Death
MGM
81
China
Healthy
-
MGF
89
Cuba
Deceased
Old Age
PGM
84
USA
Deceased
Leukemia in her 80s
PGF
88
USA
Healthy, not as active
-
SIB=Sibling F=Female M=Male MGM=Maternal Grandmother MGF=Maternal Grandfather PGM=Paternal Grandmother PGF=Paternal Grandfather OFS=Donor Offspring
PERSONAL AND EDUCATIONAL DATA Marital Status Occupation:
(S/M/D) :
Single
No. of Children:
Software Engineer
0
Degree/Major:
No. of Siblings:
1
Mathematics with Computer Science
Career Goals: Manage a team; Start a company; Create enough passive investments to support a family passively Hobbies/Interests: Wrestling, Weightlifting, Nepalese Culture, Real Estate Investing, Stock Market, Economics, Behavioral Psychology, Game Theory, Music Composition Describes himself as: I am a smart, athletic, empathetic individual who tries to optimize every situation. I have incredible willpower and can delay gratification for long periods of time. I am very confident and enjoy interacting with other people. I see bad things in the world and want to fix them. Special Skills, Talents, Abilities: Deadlift 460lbs. Musical Improv. Cooking. Foreign Languages: Limited Working Spanish Favorite Movies: Ex Machina Favorite Music:
Electric Dance Music
www.ManhattanCryobank.com ANDR OLOG Y L ABO RATO RY
REP ROD UCT IVE
TISS UE BANK SE RV ICES
S P ERM C RY O B AN KING E MBR YO /E GG S T ORA GE D O NOR S PERM
211 E AST 43 R D S TREET , S UITE 1701, N EW Y ORK , NY 10017 T EL : 212.396.2796 F AX : 212.396.2797
[email protected]
SHORT PROFILE – DONOR CODE 5924 PERSONAL STATEMENTS What is your ultimate goal in life? I want to start a family and teach my children to make the world a better place while providing a wonderful childhood for them. I also want to live long enough to see humanity’s great technological achievements in artificial intelligence. How would your friends and family describe you? Smart, confident, hard-working, stubborn, compassionate, thoughtful, active, independent, headstrong, goofy, dreamer, successful, inspirational, calm, rational, quick-witted, funny, creative, sensitive, out-going, brave If you could pass a message to the recipient of your semen, what would that be? I consider myself very blessed because my parents gave me (1) exceptional DNA, and (2) endless time and love. I want to make the world a better place by sharing #1 with you and request that you give your children #2. Is there anything special you want to share? My girlfriend and I are waiting until marriage to have sex. Once we do, we plan on having two or three children. It would make me very happy to help other couples share that same dream when they are otherwise unable to do so. My great-grandfather lived to 104. My grandmother played tennis every day. DONOR / FAMILY MEDICAL HISTORY Medical History
Donor
Relatives
Circulatory (Blood/Heart)
None Known
None Known
Gastrointestinal
None Known
None Known
Genital/Reproductive
None Known
None Known
Integumentary (Skin)
None Known
None Known
Mental Health
None Known
None Known
Metabolic/Endocrine
None Known
None Known
Musculo/Skeletal (Muscle/Bones/Joints)
None Known
PGF – Gout (but changed diet and eliminated symptoms)
Neurological
None Known
None Known
Respiratory (Lungs)
None Known
None Known
Sight/Sound/Smell
None Known
None Known
Urinary
None Known
None Known
Allergies
None Known
None Known
Birth Defects
None Known
None Known
Cancer
None Known
PGM – Leukemia; Aunt had breast lump removed in mid 70s and has had no relapse (Benign growth, has never been diagnosed with breast cancer)
GENETIC TESTING No mutations detected in the following Genetic Disorders: Alpha-Thalassemia
Beta-Thalassemia
Bloom’s Syndrome
Canavan Disease
Cystic Fibrosis
Dihydrolipoamide Dehydrogenase Deficiency
Familial Dysautonomia
Familial Hyperinsulinism
Fanconi Anemia Group C
Gaucher Disease
Glycogen Storage Disease Type Ia
Joubert Syndrome 2
Maple Syrup Urine Disease Type 1A/1B
Mucolipidosis Type IV
Nemaline Myopathy
Niemann-Pick Disease Type A/B
Sickle Cell Disease
Spinal Muscular Atrophy (SMA)
Tay-Sachs Disease (DNA,ENZ)
Usher Syndrome Type IF
Usher Syndrome Type III
Walker-Warburg Syndrome
CHROMOSOME ANALYSIS 46,XY Normal Male Karyotype
www.ManhattanCryobank.com ANDR OLOG Y L ABO RATO RY
REP ROD UCT IVE
TISS UE BANK SE RV ICES
S P ERM C RY O B AN KING E MBR YO /E GG S T ORA GE D O NOR S PERM
