Summary Profile

Download AS PDF

Donor Number: 5042

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?	No
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	57
Health Problem	Healthy
Living / Dead	Living

Your Father

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

Brothers

Your Brother 1

Question	Response	Comment/Age Affected
Current age or age at death	27	Maternal half brother
Health Problem	Healthy
Living / Dead	Living

Your Mother's Father

Question	Response	Comment/Age Affected
Current age or age at death	87
Health Problem	Healthy
Health Problem	Cause of death: Heart failure	87
Living / Dead	Dead

Your Mother's Mother

Question	Response	Comment/Age Affected
Current age or age at death	90
Health Problem	Healthy
Health Problem	Cause of death: Heart failure	90
Living / Dead	Dead

Your Mother's Sisters 1

Question	Response	Comment/Age Affected
Current age or age at death	56
Health Problem	Breast cancer, treated with surgery	56
Health Problem	Cause of death: Breast cancer	56
Living / Dead	Dead

Your Father's Father

Question	Response	Comment/Age Affected
Current age or age at death	97
Health Problem	Healthy
Health Problem	Cause of death: Heart failure	97
Living / Dead	Dead

Your Father's Mother

Question	Response	Comment/Age Affected
Current age or age at death	88
Health Problem	Healthy
Health Problem	Cause of death: Heart failure	88
Living / Dead	Dead

Your Father's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	67
Health Problem	Colon cancer, treated with chemotherapy	60
Health Problem	Cause of death: Colon cancer	67
Living / Dead	Dead

Religion:

Updates to Profile