FINAL Patient Information Epsteln,Jeffrey SSN: DOB: 01/20/1953 Patient Id: 1371344 Phone: 212-750-9895 Sperimm 71383160F Lab 137115 el =a2 Brooklyn Naiy Yard. Building 292 63 Flushing Alcune. Brooklyn. New York 11205 718-552-1000 Fax 718452-1022 Nkatkal Director Pautcot R Romano. NI D Account Information City MD 336 E. 86th St. New York. NY 10028 Mazer.Gary DmcConcocd Daucticcrived Date Reported 10/09/2011 09:53PM 10/09/2011 10/12/2011 Sex M Age 58 TESTS Chemistry Glucose Criteria for the diagnosis of diabetes: [Fasting Glucose] <100 mg/dL: Normal fasting glucose 100-125 mg/dL: Impaired fasting glucose RESULTS H In REFERENCE VALUES 65 - 99 mg/dL >125 mg/dL: Indicative of diabetes Ref: Diabetes Care 29:543-548, 2006 Urea Nitrogen. 23 7 - 25 mg/dL Creatinine H 1.55 0.5 - 1.3 mg/dL EGFR L 46 >60 - For African-Americans, multiply EGFR result x 1.2 BUN/Crest Ratio 14.8 5.3 - 50.0 Sodium 140 135 - 146 mEq/L Potassium 4.1 3.5 - 5.5 mmol/L Chloride 103 98 - 110 mEq/L Carbon Dioxide 27 21 - 33 mEq/L Calcium 9.5 8.6 10.4 mg/dL Protein, Total 7.1 6.2 8.3 g/dL Albumin 4.5 3.6 - 5.3 g/dL Globulin 2.6 2.1 3.7 g/dL A/G Ratio 1.7 Ratio Alkaline Phosphatase 60 40 - 115 IU/L AST (SOOT] 38 10 - 40 IU/L ALT (San] 49 9 - 60 IU/L Bilirubin, Total 0.6 0.2 - 1.2 mg/dL Hematology White Blood Count 7.4 4.0 - 11.0 x10"3/uL Red Blood Count 4.82 4.2 - 6.0 x10"6/1.11, Continued on Next Page Page 1 of 3 EFTA01126522 FINAL Patient Information Epstein,Jeffrey SSN: DOB: 01/20/1953 Patient Id: 1371344 Phone: 212-750-9895 I Spetthien4 171383160F 137115 Pia i e 1 =lima= Brook!, n \MN Inrd. Building 292 03 Flushing As cone. Brooklyn. Nen York 11205 718-552-1000 Fax 718-552-1022 Medical Director Priem R ROT:1110.M I) Ls, ,AS Account Information City MD 336 E. 86th St. New York, NY 10028 Mazer,Gary Dwi:ColkaW Daly Recrixed I Bate Reported 1 10/09/2011 I 09:53PM 1 ommo 1 1 1 om 2/2011 TESTS RESULTS Hemoglobin 14.4 Hematocrit 40.8 MCV 85 MCH 29.9 MCHC 35.3 Neutrophils% 53.8 Lymphocytes% 33.2 Monocytes% 7.5 Eosinophils% H 4.8 Easophils% 0.6 Neutrophils, Abs 4.0 Lymphocytes, Abs 2.5 Monocytes, Abs 0.6 Eosinophils, Absolute 0.4 Basophils, Abs. 0.1 RDW-CV 13.5 Platelets 333 NPV L 7.7 ESR-Westergren 15 Special Chemistry Calcium, Ionized 5.2 <8 months: No Reference Range Established 8 months-10 years: 4.9-5.4 mg/dL 11-17 years: 4.8-5.3 mg/dL Endocrinology Thyroxine [T41 9.0 T3-Uptake 33.1 TSH 3rd Generation 2.18 T3, Total 102 Sex M Ate 58 REFERENCE VALUES 12.5 - 16.1 38 52 78 102 27 - 31 31 - 37 40 - 70 20 - 40 2 - 10 1 - 4 0 - 1 1.6 - 7.8 1.0 - 4.5 <1.0 <0.7 <0.3 11 - 16 150 - 450 8.0 - 13 0 - 20 4.8 - 5.6 4.5 - 10.9 22.5 - 37.0 0.545 - 4.784 60 - 181 g/dL fL pg g/dL x10"3/uL x10"3/uL xl0 A 3/uL xl0 A 3/uL xl0 A 3/uL x10"3/uL fL mm/hr mg/dL ug/dL uIU/mL ng/dL Continued on Next Page Page 2 of 3 EFTA01126523 FINAL Patient Information Epsteln,Jeffrey SSN: DOS: 01/20/1953 Patient Id: 1371344 Phone: 212-750-9895 Specimen # T1383160F Lab # 137115 iel Rrookhn Nary Yard. Building 292 (3 Hushing A‘ cone. Brooklyn. Nen York 11205 718.552-1000 Fax 7IS452-I022 Medical Director PilfiC13 R Romano. M 0 tato.:a. If /tune ht Account Information City MD 336 E. 86th St. New York, NY 10028 Mazer,Gary Dale Collected Dale Received Date Reported 10/09/2011 09:53PM 10/09/2011 10/12/2011 Sex M Aft 58 TESTS RESULTS REFERENCE VALUES T4, Free PTH-/ntact *Performed By Nichols Institute 1.32 H 107 0.8 - 1.8 14 - 72 ng/dL pg/aL End of Final Report Page 3 of 3 EFTA01126524