Summary Profile

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Donor Number: 4330

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 - Maternal grandfather, onset in his middle age
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 - Cats: Itchy eyes
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	65
Health Problem	Glaucoma, diagnosed in her 30s, treated with eye drops and surgery	35
Living / Dead	Living

Your Father

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

Sisters

Your Sister 1

Question	Response	Comment/Age Affected
Current age or age at death	44	(Half-sister)
Health Problem	Migraines, treated with over-the-counter medications (she no longer suffers migraines)	39
Living / Dead	Living

Your Sister 2

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	89
Health Problem	Phlebitis (heavy drinker and smoker), treated in hospital	89
Health Problem	Cause of death: Phlebitis	89
Living / Dead	Dead

Your Mother's Mother

Question	Response	Comment/Age Affected
Current age or age at death	86
Health Problem	Accidental fall, hospitalized without severe injury, died of natural causes	86
Health Problem	Cause of death: Natural causes	86
Living / Dead	Dead

Your Mother's Sisters 1

Question	Response	Comment/Age Affected
Current age or age at death	63
Health Problem	Multiple Sclerosis, treatment unknown	40
Living / Dead	Living

Your Father's Father

Question	Response	Comment/Age Affected
Current age or age at death	91
Health Problem	Pneumonia, treated with antibiotics	91
Health Problem	Cause of death: Pneumonia	91
Living / Dead	Dead

Your Father's Mother

Question	Response	Comment/Age Affected
Current age or age at death	94
Health Problem	Healthy
Living / Dead	Living

Your Father's Sisters 1

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

Your Father's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	67
Health Problem	Healthy
Living / Dead	Living

Religion:

Updates to Profile