Donor 5335 - Summary 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 - Far-sighted
Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused:	No
CMV IgG Antibody	Negative
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	63
Health Problem	Healthy
Living / Dead	Living

Sisters

Your Sister 1

Question	Response	Comment/Age Affected
Current age or age at death	40	Paternal half sister
Health Problem	Healthy
Living / Dead	Living

Your Sister 2

Question	Response	Comment/Age Affected
Current age or age at death	38	Paternal half sister
Health Problem	Healthy
Living / Dead	Living

Your Sister 3

Question	Response	Comment/Age Affected
Current age or age at death	35
Health Problem	Healthy
Living / Dead	Living

Sons

Your Son 1

Question	Response	Comment/Age Affected
Current age or age at death	7
Health Problem	Healthy
Living / Dead	Living

Your Son 2

Question	Response	Comment/Age Affected
Current age or age at death	6
Health Problem	Healthy
Living / Dead	Living

Daughters

Your Daughter 1

Question	Response	Comment/Age Affected
Current age or age at death	2
Health Problem	Healthy
Living / Dead	Living

Your Mother's Father

Question	Response	Comment/Age Affected
Current age or age at death	85
Health Problem	Healthy
Health Problem	Cause of death: Heart failure	85
Living / Dead	Dead

Your Mother's Mother

Question	Response	Comment/Age Affected
Current age or age at death	75
Health Problem	Organ failure, cause unknown	75
Health Problem	Cause of death: Organ failure	75
Living / Dead	Dead

Your Mother's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	60
Health Problem	Healthy
Living / Dead	Living

Your Mother's Brothers 2

Question	Response	Comment/Age Affected
Current age or age at death	57
Health Problem	Healthy
Living / Dead	Living

Your Father's Father

Question	Response	Comment/Age Affected
Current age or age at death	83
Health Problem	Healthy
Living / Dead	Living

Your Father's Mother

Question	Response	Comment/Age Affected
Current age or age at death	66
Health Problem	Organ failure, unknown cause	66
Health Problem	Cause of death: Organ failure	66
Living / Dead	Dead

Your Father's Sisters 1

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

Your Father's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	65
Health Problem	Healthy
Living / Dead	Living

Your Father's Brothers 2

Question	Response	Comment/Age Affected
Current age or age at death	60
Health Problem	Infection of a wound following an accident, treatment (if any) unknown	60
Health Problem	Cause of death: Complications of wound infection	60
Living / Dead	Dead

Your Father's Brothers 3

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

Height: 177 cm (5'10")	Weight: 97 kg (215 lb)	Eye Color: Hazel	Hair: Black/ Wavy	Skin Tone: Medium Light	Ancestry: Latino
	Blood Type: A+	Ethnic Background: Puerto Rican-Spanish/Italian-Puerto Rican
	Education: ThD/Theology		Occupation: Pastor
Interests:	Camping, Hiking, Reading

Faith	Christian
Denomination	Non-denominational

Donor Number: 5335

Physical

Medical

Family Medical History
See list of questions asked here

Religion:

Updates to Profile

Update Available	N/A
Updates - Personal	N/A
Updates - Medical	N/A
Updates - Family Medical History	N/A

Donor Number: 5335

Physical

Medical

Family Medical HistorySee list of questions asked here

Religion:

Updates to Profile

Family Medical History
See list of questions asked here