Donor 5501 - 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?	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	54
Health Problem	Healthy
Living / Dead	Living

Your Father

Question	Response	Comment/Age Affected
Current age or age at death	57
Health Problem	High cholesterol, controlled with medication	40
Living / Dead	Living

Brothers

Your Brother 1

Question	Response	Comment/Age Affected
Current age or age at death	32
Health Problem	Kidney stones, treatment for pain only	23
Living / Dead	Living

Sons

Your Son 1

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

Daughters

Your Daughter 1

Question	Response	Comment/Age Affected
Current age or age at death	4
Health Problem	Healthy
Living / Dead	Living

Your Mother's Father

Question	Response	Comment/Age Affected
Current age or age at death	82
Health Problem	Healthy
Living / Dead	Living

Your Mother's Mother

Question	Response	Comment/Age Affected
Current age or age at death	79
Health Problem	Healthy
Living / Dead	Living

Your Mother's Sisters 1

Question	Response	Comment/Age Affected
Current age or age at death	53
Health Problem	Rheumatoid arthritis, treated with over-the-counter medication	40
Living / Dead	Living

Your Mother's Sisters 2

Question	Response	Comment/Age Affected
Current age or age at death	52
Health Problem	Healthy
Living / Dead	Living

Your Mother's Sisters 3

Question	Response	Comment/Age Affected
Current age or age at death	48
Health Problem	Healthy
Living / Dead	Living

Your Mother's Brothers 1

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

Your Mother's Brothers 2

Question	Response	Comment/Age Affected
Current age or age at death	56
Health Problem	Healthy
Living / Dead	Living

Your Mother's Brothers 3

Question	Response	Comment/Age Affected
Current age or age at death	51
Health Problem	Healthy
Living / Dead	Living

Your Father's Father

Question	Response	Comment/Age Affected
Current age or age at death	78
Health Problem	Heart attack, mild, treated with medication	75
	Brain cancer, treated with radiation and chemotherapy	77
	Cause of death: Brain cancer	78
Living / Dead	Dead

Your Father's Mother

Question	Response	Comment/Age Affected
Current age or age at death	77
Health Problem	Healthy
Living / Dead	Living

Your Father's Sisters 1

Question	Response	Comment/Age Affected
Current age or age at death	55	(fraternal twin)
Health Problem	Healthy
Living / Dead	Living

Your Father's Sisters 2

Question	Response	Comment/Age Affected
Current age or age at death	55	(fraternal twin)
Health Problem	Healthy
Living / Dead	Living

Your Father's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	53
Health Problem	Healthy
Living / Dead	Living

Height: 6'2" (187 cm)	Weight: 160 lb (72 kg)	Eye Color: Hazel	Hair: Blond/ Straight	Skin Tone: Light	Ancestry: Caucasian
	Blood Type: O+	Ethnic Background: German/English-German
	Education: Associate's/Industrial Tech.		Occupation: Electronics, Sales, Medical
Interests:	Gardening, Hiking, Kayaking, Social Justice

Faith	None
Denomination	N/A

Donor Number: 5501

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: 5501

Physical

Medical

Family Medical HistorySee list of questions asked here

Religion:

Updates to Profile

Family Medical History
See list of questions asked here