Summary Profile

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Donor Number: 5378

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 - Far-sighted
Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused:	Yes - Penicillin: Causes rash
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	45
Health Problem	Hypoglycemia, controlled with diet	30
Living / Dead	Living

Your Father

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

Sisters

Your Sister 1

Question	Response	Comment/Age Affected
Current age or age at death	11	Paternal half sister
Health Problem	Healthy
Living / Dead	Living

Your Sister 2

Question	Response	Comment/Age Affected
Current age or age at death	10	Paternal half sister
Health Problem	Healthy
Living / Dead	Living

Your Sister 3

Question	Response	Comment/Age Affected
Current age or age at death	9	Maternal half sister
Health Problem	Healthy
Living / Dead	Living

Your Mother's Father

Question	Response	Comment/Age Affected
Current age or age at death	55
Health Problem	Heart disease, treatment unknown	52
	Heart attack, fatal, no treatment	55
	Cause of death: Heart attack	55
Living / Dead	Dead

Your Mother's Mother

Question	Response	Comment/Age Affected
Current age or age at death	75
Health Problem	Rheumatoid arthritis and osteoarthritis, mild, no treatment currently	60
Living / Dead	Living

Your Mother's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	16
Health Problem	Healthy
Health Problem	Cause of death: Gunshot (murdered)	16
Living / Dead	Dead

Your Mother's Brothers 2

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

Your Father's Father

Question	Response	Comment/Age Affected
Current age or age at death	80
Health Problem	Parkinson's, managed with medication and assisted care	75
Living / Dead	Living

Your Father's Mother

Question	Response	Comment/Age Affected
Current age or age at death	74
Health Problem	Lung cancer (smoker), treated with chemotherapy and radiation	71
Health Problem	Cause of death: Lung cancer, metastasized to the liver	74
Living / Dead	Dead

Your Father's Sisters 1

Question	Response	Comment/Age Affected
Current age or age at death	43
Health Problem	Healthy
Living / Dead	Living

Religion:

Updates to Profile