Donor 5003 - 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 - 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	55
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, treated with medication	54
Health Problem	High cholesterol, treated with medication	54
Living / Dead	Living

Brothers

Your Brother 1

Question	Response	Comment/Age Affected
Current age or age at death	29
Health Problem	Healthy
Living / Dead	Living

Sisters

Your Sister 1

Question	Response	Comment/Age Affected
Current age or age at death	28
Health Problem	Kidney stones, no treatment, passed naturally	25
Living / Dead	Living

Your Sister 2

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

Your Mother's Father

Question	Response	Comment/Age Affected
Current age or age at death	68
Health Problem	Influenza, no treatment (did not believe in modern medicine)	68
Health Problem	Cause of death: Complications of influenza	68
Living / Dead	Dead

Your Mother's Mother

Question	Response	Comment/Age Affected
Current age or age at death	72
Health Problem	Influenza, no treatment (did not believe in modern medicine)	72
Health Problem	Cause of death: Complications of influenza	72
Living / Dead	Dead

Your Mother's Sisters 1

Question	Response	Comment/Age Affected
Current age or age at death	49
Health Problem	Healthy
Living / Dead	Living

Your Mother's Sisters 2

Question	Response	Comment/Age Affected
Current age or age at death	42
Health Problem	Healthy
Living / Dead	Living

Your Mother's Brothers 1

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

Your Mother's Brothers 2

Question	Response	Comment/Age Affected
Current age or age at death	45
Health Problem	Healthy
Living / Dead	Living

Your Father's Father

Question	Response	Comment/Age Affected
Current age or age at death	71
Health Problem	Healthy
Health Problem	Cause of death: Car accident	71
Living / Dead	Dead

Your Father's Mother

Question	Response	Comment/Age Affected
Current age or age at death	83
Health Problem	Influenza (or flu-like illness), no health care access, home remedies only	83
Health Problem	Cause of death: Influenza (or flu-like illness)	83
Living / Dead	Dead

Your Father's Sisters 1

Question	Response	Comment/Age Affected
Current age or age at death	63
Health Problem	Healthy
Living / Dead	Living

Your Father's Sisters 2

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

Your Father's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	69
Health Problem	Healthy
Living / Dead	Living

Your Father's Brothers 2

Question	Response	Comment/Age Affected
Current age or age at death	46
Health Problem	Healthy
Living / Dead	Living

Height: 5'8" (172 cm)	Weight: 135 lb (61 kg)	Eye Color: Brown	Hair: Black/ Straight	Skin Tone: Medium	Ancestry: Asian
	Blood Type: B+	Ethnic Background: Pakistani/Pakistani
	Education: BS/Psychology, BA/Biology		Occupation: Cashier/Data Collector
Interests:	Football, Soccer

Faith	Islam
Denomination	Sunni

Donor Number: 5003

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: 5003

Physical

Medical

Family Medical HistorySee list of questions asked here

Religion:

Updates to Profile

Family Medical History
See list of questions asked here