Donor 5129 - 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	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	60
Health Problem	Stroke (resulting from toxic shock syndrome), treated with surgery	33
Health Problem	Limited mobility and slight speech impediment (due to stroke), treated with physical therapy	33
Living / Dead	Living

Your Father

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

Sisters

Your Sister 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	57
Health Problem	Severe trauma due to car accident, no treatment	57
Health Problem	Cause of death: Severe trauma	57
Living / Dead	Dead

Your Mother's Mother

Question	Response	Comment/Age Affected
Current age or age at death	85
Health Problem	Heart failure, no treatment	85
Health Problem	Cause of death: Heart failure	85
Living / Dead	Dead

Your Mother's Sisters 1

Question	Response	Comment/Age Affected
Current age or age at death	65
Health Problem	Healthy
Living / Dead	Living

Your Mother's Sisters 2

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

Your Mother's Sisters 3

Question	Response	Comment/Age Affected
Current age or age at death	62
Health Problem	Healthy
Living / Dead	Living

Your Mother's Sisters 4

Question	Response	Comment/Age Affected
Current age or age at death	57
Health Problem	Post-traumatic Stress Disorder (PTSD) due to military service, age at diagnosis unknown
	Depression due to PTSD, treated with medication	20
	Obesity (due to depression and lack of activity), no treatment	20
Living / Dead	Living

Your Mother's Sisters 5

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

Your Mother's Sisters 6

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

Your Mother's Brothers 1

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

Your Mother's Brothers 2

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

Your Father's Father

Question	Response	Comment/Age Affected
Current age or age at death	90
Health Problem	Heart attack, no treatment	90
Health Problem	Cause of death: Heart attack	90
Living / Dead	Dead

Your Father's Mother

Question	Response	Comment/Age Affected
Current age or age at death	96
Health Problem	Healthy
Living / Dead	Living

Your Father's Sisters 1

Question	Response	Comment/Age Affected
Current age or age at death	61
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	Lung cancer (smoker), no treatment	69
Health Problem	Cause of death: Lung cancer	69
Living / Dead	Dead

Your Father's Brothers 2

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

Height: 5'7" (170 cm)	Weight: 143 lb (64 kg)	Eye Color: Hazel	Hair: Brown/ Straight	Skin Tone: Medium Light	Ancestry: Multi
	Blood Type: A+	Ethnic Background: German/Japanese
	Education: BS/Mechanical Engineering		Occupation: Student
Interests:	Leadership, Singing, Tennis

Faith	Christian
Denomination	Non-denominational

Update Available	Yes
Updates - Personal	N/A
Updates - Medical	Update 2018: Donor has been diagnosed with ADHD in his 30's. Any future sales or vial shipments will require an informed consent.
Updates - Family Medical History	N/A

Donor Number: 5129

Physical

Medical

Family Medical History
See list of questions asked here

Religion:

Updates to Profile

Donor Number: 5129

Physical

Medical

Family Medical HistorySee list of questions asked here

Religion:

Updates to Profile

Family Medical History
See list of questions asked here