Summary Profile

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Donor Number: 4819

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:	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	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	51
Health Problem	Benign thyroid tumor, removed with surgery	51
Living / Dead	Living

Your Father

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

Brothers

Your Brother 1

Question	Response	Comment/Age Affected
Current age or age at death	25
Health Problem	Healthy
Living / Dead	Living

Your Mother's Father

Question	Response	Comment/Age Affected
Current age or age at death	97
Health Problem	Heart failure, no treatment	97
Health Problem	Cause of death: Heart failure	97
Living / Dead	Dead

Your Mother's Mother

Question	Response	Comment/Age Affected
Current age or age at death	86
Health Problem	Situational depression, controlled with medication	84
Living / Dead	Living

Your Mother's Sisters 1

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

Your Mother's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	62
Health Problem	Pancreatic cancer, attempted treatment with radiation	62
Health Problem	Cause of death: Pancreatic cancer	62
Living / Dead	Dead

Your Mother's Brothers 2

Question	Response	Comment/Age Affected
Current age or age at death	60
Health Problem	Bipolar disorder, controlled with medication	40
Living / Dead	Living

Your Father's Father

Question	Response	Comment/Age Affected
Current age or age at death	73
Health Problem	High blood pressure, controlled with medication	65
Living / Dead	Living

Your Father's Mother

Question	Response	Comment/Age Affected
Current age or age at death	73
Health Problem	Obese, no treatment	60
Living / Dead	Living

Your Father's Sisters 1

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

Your Father's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	50
Health Problem	Healthy
Living / Dead	Living

Religion:

Updates to Profile