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Donor Number: 1482

Profile:

Family Medical History

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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:	Yes - Paternal grandfather, age 55
Any dietary restrictions? If yes, explain:	N/A
Do you wear glasses or contact lenses? Are you near or far-sighted?	N/A
Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused:	Yes - Bee and wasp stings, cedar, mold
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	55
Health Problem	Diet controlled high blood pressure
Living / Dead	Living

Brothers

Your Brother 1

Question	Response	Comment/Age Affected
Current age or age at death	34
Health Problem	Healthy
Living / Dead	Living

Your Mother's Father

Question	Response	Comment/Age Affected
Current age or age at death	67
Health Problem	Lung cancer - smoker	66
	Laminectomy	60
	Back problems - occupational	55
	Osteoarthritis	50
Living / Dead	Dead

Your Mother's Mother

Question	Response	Comment/Age Affected
Current age or age at death	84
Health Problem	Broken hip, not as mobile but still healthy	82
Health Problem	Osteoarthritis	75
Living / Dead	Living

Your Mother's Sisters 1

Question	Response	Comment/Age Affected
Current age or age at death	53
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	Overweight, possible high blood pressure
Living / Dead	Living

Your Father's Father

Question	Response	Comment/Age Affected
Current age or age at death	85
Health Problem	Adult onset diabetes	75
	Alcoholism - Sciatica - walks with cane	55
	High blood pressure	60
Living / Dead	Living

Your Father's Mother

Question	Response	Comment/Age Affected
Current age or age at death	74
Health Problem	Acid reflux disease / esophageal cancer	72
Living / Dead	Dead

Your Father's Sisters 1

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

Your Father's Sisters 2

Question	Response	Comment/Age Affected
Current age or age at death	50
Health Problem	Anorexia nervosa (recovered)	20
Living / Dead	Living

Your Father's Sisters 3

Question	Response	Comment/Age Affected
Current age or age at death	41
Health Problem	Healthy
Living / Dead	Living

Religion:

Updates to Profile