Summary Profile

Download AS PDF

Donor Number: 5334

Profile:

Family Medical History

Updates to Profile

Physical

Medical

Question	Response
Have you or any of your family members been diagnosed with alcoholism or drug addiction? If yes, relation and age affected:	No
Any dietary restrictions? If yes, explain:	No
Do you wear glasses or contact lenses? Are you near or far-sighted?	Yes - Near-sighted
Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused:	No
CMV IgG Antibody	Positive
CMV IgM Antibody	Negative
Note any comments regarding above items:	N/A

Family Medical History
See list of questions asked here

Your Mother

Question	Response	Comment/Age Affected
Current age or age at death	64
Health Problem	Healthy
Living / Dead	Living

Your Father

Question	Response	Comment/Age Affected
Current age or age at death	60
Health Problem	High blood pressure (controlled with lifestyle changes and diet)	45
	High cholesterol (controlled with lifestyle changes and diet)	45
	Heart attack (fatal, no treatment)	60
	Cause of death: Heart attack	60
Living / Dead	Dead

Sons

Your Son 1

Question	Response	Comment/Age Affected
Current age or age at death	0.5	(twin)
Health Problem	Healthy
Living / Dead	Living

Daughters

Your Daughter 1

Question	Response	Comment/Age Affected
Current age or age at death	0.5	(twin)
Health Problem	Healthy
Living / Dead	Living

Your Mother's Father

Question	Response	Comment/Age Affected
Current age or age at death	83
Health Problem	Stroke (fatal, no treatment)	83
Health Problem	Cause of death: Stroke	83
Living / Dead	Dead

Your Mother's Mother

Question	Response	Comment/Age Affected
Current age or age at death	81
Health Problem	Diabetes (treated with insulin)	66
	Blood clot (treatment unknown)	81
	Cause of death: Blood clot travelled to lungs	81
Living / Dead	Dead

Your Mother's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	66
Health Problem	Healthy
Living / Dead	Living

Your Father's Father

Question	Response	Comment/Age Affected
Current age or age at death	82
Health Problem	Pneumonia (treated with hospitalization)	82
Health Problem	Cause of death: Pneumonia	82
Living / Dead	Dead

Your Father's Mother

Question	Response	Comment/Age Affected
Current age or age at death	86
Health Problem	Bone infection after breaking a bone in a fall (treated with hospitalization)	86
Health Problem	Cause of death: Bone infection	86
Living / Dead	Dead

Your Father's Sisters 1

Question	Response	Comment/Age Affected
Current age or age at death	62
Health Problem	Healthy
Living / Dead	Living

Your Father's Sisters 2

Question	Response	Comment/Age Affected
Current age or age at death	58
Health Problem	Healthy
Living / Dead	Living

Your Father's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	64
Health Problem	Healthy
Living / Dead	Living

Religion:

Updates to Profile